WO2013106787A1 - Chimeric factor viii polypeptides and uses thereof - Google Patents

Chimeric factor viii polypeptides and uses thereof Download PDF

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Publication number
WO2013106787A1
WO2013106787A1 PCT/US2013/021330 US2013021330W WO2013106787A1 WO 2013106787 A1 WO2013106787 A1 WO 2013106787A1 US 2013021330 W US2013021330 W US 2013021330W WO 2013106787 A1 WO2013106787 A1 WO 2013106787A1
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Prior art keywords
fviii
vwf
chimeric protein
protein
seq
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PCT/US2013/021330
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English (en)
French (fr)
Inventor
Ekta Seth CHHABRA
Tongyao Liu
Robert Peters
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Biogen Idec Ma Inc.
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Publication date
Priority to JP2014552353A priority Critical patent/JP6255630B2/ja
Priority to EP13735649.9A priority patent/EP2804623B1/en
Application filed by Biogen Idec Ma Inc. filed Critical Biogen Idec Ma Inc.
Priority to KR1020147022369A priority patent/KR102212098B1/ko
Priority to DK13735649T priority patent/DK2804623T3/da
Priority to NZ626945A priority patent/NZ626945A/en
Priority to CA2863328A priority patent/CA2863328A1/en
Priority to MX2014008512A priority patent/MX357403B/es
Priority to CN201380013452.7A priority patent/CN104271150A/zh
Priority to PL13735649T priority patent/PL2804623T3/pl
Priority to EP18211179.9A priority patent/EP3505179A1/en
Priority to US14/371,948 priority patent/US11370827B2/en
Priority to SG11201403764XA priority patent/SG11201403764XA/en
Priority to ES13735649T priority patent/ES2753124T3/es
Priority to SI201331602T priority patent/SI2804623T1/sl
Priority to EA201491186A priority patent/EA028309B1/ru
Priority to LT13735649T priority patent/LT2804623T/lt
Priority to AU2013205647A priority patent/AU2013205647B8/en
Priority to RS20191424A priority patent/RS59670B1/sr
Priority to BR112014017165-3A priority patent/BR112014017165B1/pt
Publication of WO2013106787A1 publication Critical patent/WO2013106787A1/en
Priority to IL233463A priority patent/IL233463B/en
Priority to PH12014501602A priority patent/PH12014501602B1/en
Priority to HK15103334.2A priority patent/HK1202799A1/xx
Priority to AU2016202875A priority patent/AU2016202875B2/en
Priority to AU2018201163A priority patent/AU2018201163B2/en
Priority to PH12018501250A priority patent/PH12018501250A1/en
Priority to IL261632A priority patent/IL261632B/en
Priority to HRP20191920TT priority patent/HRP20191920T1/hr
Priority to CY20191101171T priority patent/CY1122509T1/el
Priority to US17/826,932 priority patent/US20230011438A1/en

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    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K14/00—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
    • C07K14/435—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans
    • C07K14/745—Blood coagulation or fibrinolysis factors
    • C07K14/755—Factors VIII, e.g. factor VIII C (AHF), factor VIII Ag (VWF)
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K19/00—Hybrid peptides, i.e. peptides covalently bound to nucleic acids, or non-covalently bound protein-protein complexes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K38/00—Medicinal preparations containing peptides
    • A61K38/16—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
    • A61K38/17—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans
    • A61K38/36—Blood coagulation or fibrinolysis factors
    • A61K38/37—Factors VIII
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/50—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/50—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates
    • A61K47/51—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent
    • A61K47/62—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being a protein, peptide or polyamino acid
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P7/00—Drugs for disorders of the blood or the extracellular fluid
    • A61P7/04—Antihaemorrhagics; Procoagulants; Haemostatic agents; Antifibrinolytic agents
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K16/00—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies
    • C—CHEMISTRY; METALLURGY
    • C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
    • C12N—MICROORGANISMS OR ENZYMES; COMPOSITIONS THEREOF; PROPAGATING, PRESERVING, OR MAINTAINING MICROORGANISMS; MUTATION OR GENETIC ENGINEERING; CULTURE MEDIA
    • C12N15/00—Mutation or genetic engineering; DNA or RNA concerning genetic engineering, vectors, e.g. plasmids, or their isolation, preparation or purification; Use of hosts therefor
    • C12N15/09—Recombinant DNA-technology
    • C12N15/11—DNA or RNA fragments; Modified forms thereof; Non-coding nucleic acids having a biological activity
    • C12N15/62—DNA sequences coding for fusion proteins
    • C—CHEMISTRY; METALLURGY
    • C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
    • C12N—MICROORGANISMS OR ENZYMES; COMPOSITIONS THEREOF; PROPAGATING, PRESERVING, OR MAINTAINING MICROORGANISMS; MUTATION OR GENETIC ENGINEERING; CULTURE MEDIA
    • C12N15/00—Mutation or genetic engineering; DNA or RNA concerning genetic engineering, vectors, e.g. plasmids, or their isolation, preparation or purification; Use of hosts therefor
    • C12N15/09—Recombinant DNA-technology
    • C12N15/63—Introduction of foreign genetic material using vectors; Vectors; Use of hosts therefor; Regulation of expression
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K2317/00—Immunoglobulins specific features
    • C07K2317/90—Immunoglobulins specific features characterized by (pharmaco)kinetic aspects or by stability of the immunoglobulin
    • C07K2317/94—Stability, e.g. half-life, pH, temperature or enzyme-resistance
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K2319/00—Fusion polypeptide
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K2319/00—Fusion polypeptide
    • C07K2319/31—Fusion polypeptide fusions, other than Fc, for prolonged plasma life, e.g. albumin

Definitions

  • Coagulation is a complex process by which blood forms clots. It is an important part of hemostasis, the cessation of blood loss from a damaged vessel, wherein a damaged blood vessel wall is covered by a platelet and fibrin-containing clot to stop bleeding and begin repair of the damaged vessel. Disorders of coagulation can lead to an increased risk of bleeding (hemorrhage) or obstructive clotting (thrombosis).
  • Coagulation begins almost instantly after an injury to the blood vessel has damaged the endothelium lining of the vessel. Exposure of the blood to proteins such as tissue factor initiates changes to blood platelets and the plasma protein fibrinogen, a clotting factor. Platelets immediately form a plug at the site of injury; this is called primary hemostasis. Secondary hemostasis occurs simultaneously: Proteins in the blood plasma, called coagulation factors or clotting factors, respond in a complex cascade to form fibrin strands, which strengthen the platelet plug.
  • proteins such as tissue factor initiates changes to blood platelets and the plasma protein fibrinogen, a clotting factor. Platelets immediately form a plug at the site of injury; this is called primary hemostasis. Secondary hemostasis occurs simultaneously: Proteins in the blood plasma, called coagulation factors or clotting factors, respond in a complex cascade to form fibrin strands, which strengthen the platelet plug.
  • Non-limiting coagulation factors include, but are not limited to, factor I (fibrinogen), factor II (prothrombin), Tissue factor, factor V (proaccelerin, labile factor), factor VII (stable factor, proconvertin), factor VIII (Antihemophilic factor A), factor IX (Antihemophilic factor B or Christmas factor), factor X (Stuart-Prower factor), factor XI (plasma thromboplastin antecedent), factor XII (Hageman factor), factor XIII (fibrin-stabilizing factor), VWF, prekallikrein (Fletcher factor), high-molecular-weight kininogen (HMWK) (Fitzgerald factor), fibronectin, antithrombin III, heparin cofactor II, protein C, protein S, protein Z, plasminogen, alpha 2-antiplasmin, tissue plasminogen activator (tPA), urokinase, plasminogen activator inhibitor- 1 (PAI1), and plasminogen
  • Haemophilia A is a bleeding disorder caused by defects in the gene encoding coagulation factor VIII (FVIII) and affects 1-2 in 10,000 male births. Graw et al., Nat. Rev. Genet. 6(6): 488-501 (2005). Patients affected with hemophilia A can be treated with infusion of purified or recombinantly produced FVIII. All commercially available FVIII products, however, are known to have a half-life of about 8-12 hours, requiring frequent intravenous administration to the patients. See Weiner M.A. and Cairo, M.S., Pediatric Hematology Secrets, Lee, M.T., 12. Disorders of Coagulation, Elsevier Health Sciences, 2001; Lillicrap, D.
  • FVIII coagulation factor VIII
  • VWF Plasma von Willebrand Factor
  • the VWF half-life may be affected by a number of factors: glycosylation pattern, ADAMTS-13 (a disintegrin and metalloprotease with thrombospondin motif- 13), and various mutations in VWF.
  • the VWF bound to FVIII is removed from the activated FVIII.
  • the activated FVIII together with activated factor IX, calcium, and phospholipid ("tenase complex"), involves in the activation of factor X, generating large amounts of thrombin.
  • Thrombin in turn, then cleaves fibrinogen to form soluble fibrin monomers, which then spontaneously polymerize to form the soluble fibrin polymer.
  • Thrombin also activates factor XIII, which, together with calcium, serves to crosslink and stabilize the soluble fibrin polymer, forming cross-linked (insoluble) fibrin.
  • the activated FVIII is cleared fast from the circulation by proteolysis.
  • the present invention is drawn to a chimeric protein comprising a Factor VIII
  • FVIII FVIII protein and an adjunct moiety
  • A adjunct moiety
  • the adjunct moiety inhibits or prevents endogenous VWF from binding to the FVIII protein.
  • the FVIII protein and the adjunct moiety are linked to each other by a covalent bond in order to prevent dissociation of the adjunct moiety in the presence of endogenous VWF.
  • the covalent bond is a peptide bond, a disulfide bond, or a linker, which is strong enough to prevent dissociation of the adjunct moiety from the FVIII protein in the presence of endogenous VWF.
  • the adjunct moiety prevents the FVIII protein from being cleared through a VWF clearance pathway.
  • the adjunct moiety inhibits or prevents endogenous VWF from binding to the FVIII protein by shielding or blocking a VWF binding site on the FVIII protein.
  • VWF binding site is located in the A3 domain or the C2 domain of the FVIII protein or both the A3 domain and the C2 domain.
  • the chimeric protein includes a construct comprising a
  • the FVIII protein and an adjunct moiety linked to each other by a covalent bond wherein the chimeric protein does not comprise a FVIII half-life limiting factor, which induces a half- life limitation of the FVIII protein, e.g., a full-length VWF protein or a mature VWF protein. Therefore, in some embodiments, the half-life of the FVIII protein of the chimeric protein is extendable beyond the half-life limitation of the FVIII protein in the presence of endogenous VWF.
  • the adjunct moiety has at least one VWF-like FVIII protecting property.
  • the VWF-like FVIII protecting property include, but are not limited to, protecting the FVIII protein from one or more protease cleavages, protecting the FVIII protein from activation, stabilizing the heavy chain and/or the light chain of the FVIII protein, or preventing clearance of the FVIII protein by one or more scavenger receptors.
  • the adjunct moiety comprises a polypeptide, a non-polypeptide moiety, or both.
  • the adjunct moiety can be a polypeptide comprising an amino acid sequence of at least about 40, at least about 50, at least about 60, at least about 70, at least about 80, at least about 90, at least about 100, at least about 110, at least about 120, at least about 130, at least about 140, at least about 150, at least about 200, at least about 250, at least about 300, at least about 350, at least about 400, at least about 450, at least about 500, at least about 550, at least about 600, at least about 650, at least about 700, at least about 750, at least about 800, at least about 850, at least about 900, at least about 950, or at least about 1000 amino acids in length.
  • the adjunct moiety comprises a VWF fragment, an immunoglobulin constant region or a portion thereof, albumin or a fragment thereof, an albumin binding moiety, a PAS sequence, a HAP sequence, transferrin or a fragment thereof, or any combinations thereof.
  • the adjunct moiety is a non-polypeptide moiety comprising polyethylene glycol (PEG), polysialic acid, hydroxyethyl starch (HES), a derivative thereof, or any combinations thereof.
  • the adjunct moiety comprises a VWF fragment comprising a D' domain and a D3 domain of VWF, wherein the VWF fragment is associated with the FVIII protein by a non-covalent bond in addition to the covalent bond between the FVIII protein and the adjunct moiety (VWF fragment).
  • the VWF fragment is a monomer.
  • the VWF fragment comprises two, three, four, five, or six VWF fragments linked to one or more of each other.
  • the chimeric protein comprises an adjunct moiety, e.g., a VWF fragment, and at least one heterologous moiety (HI) and an optional linker between the adjunct moiety, e.g., VWF fragment, and the heterologous moiety (HI).
  • an adjunct moiety e.g., a VWF fragment
  • HI heterologous moiety
  • the heterologous moiety (HI) can comprise a moiety that extends the half- life of the FVIII protein, e.g., a polypeptide selected from the group consisting of an immunoglobulin constant region or a portion thereof, albumin or a fragment thereof, an albumin binding moiety, a PAS sequence, a HAP sequence, transferrin or a fragment thereof, and any combinations thereof or a non-polypeptide moiety selected from the group consisting of polyethylene glycol (PEG), polysialic acid, hydroxyethyl starch (HES), a derivative thereof, and any combinations thereof.
  • the heterologous moiety (HI) comprises a first Fc region.
  • the heterologous moiety (HI) comprises an amino acid sequence comprising at least about 50 amino acids, at least about 100 amino acids, at least about 150 amino acids, at least about 200 amino acids, at least about 250 amino acids, at least about 300 amino acids, at least about 350 amino acids, at least about 400 amino acids, at least about 450 amino acids, at least about 500 amino acids, at least about 550 amino acids, at least about 600 amino acids, at least about 650 amino acids, at least about 700 amino acids, at least about 750 amino acids, at least about 800 amino acids, at least about 850 amino acids, at least about 900 amino acids, at least about 950 amino acids, or at least about 1000 amino acids.
  • the chimeric protein comprises a linker between the adjunct moiety, e.g., a VWF fragment, and the heterologous moiety (HI), which is a cleavable linker.
  • the FVIII protein in the chimeric protein comprises FVIII and at least one heterologous moiety (H2).
  • the heterologous moiety (H2) is capable of extending the half-life of the FVIII protein, e.g., a polypeptide selected from the group consisting of an immunoglobulin constant region or a portion thereof, albumin or a fragment thereof, an albumin binding moiety, a PAS sequence, a HAP sequence, transferrin or a fragment thereof, and any combinations thereof or a non-polypeptide moiety comprising polyethylene glycol (PEG), polysialic acid, hydroxyethyl starch (HES), a derivative thereof, and any combinations thereof.
  • the heterologous moiety (H2) comprises a second Fc region.
  • the chimeric protein comprises a first polypeptide chain comprising the VWF fragment, a first heterologous moiety, and a linker and a second polypeptide chain comprising the FVIII protein and a second heterologous moiety, wherein the first polypeptide chain and the second polypeptide chain are linked to each other by a covalent bond.
  • the first heterologous moiety and the second heterologous moiety are linked to each other by the covalent bond, e.g., a disulfide bond, a peptide bond, or a linker, wherein the covalent bond prevents replacement of the VWF fragment in the first polypeptide chain with endogenous VWF in vivo.
  • the linker between the FVIII protein and the second heterologous moiety is a cleavable linker.
  • the first heterologous moiety (HI) linked to the VWF fragment and the second heterologous moiety (H2) linked to the FVIII protein are linked by a linker, e.g., a scFc linker, which is a processable linker.
  • the FVIII protein in the chimeric protein further comprises a third heterologous moiety (H3), a fourth heterologous moiety (H4), a fifth heterologous moiety (H5), a sixth heterologous moiety (H6), or any combinations thereof.
  • one or more of the third heterologous moiety (H3), the fourth heterologous moiety (H4), the fifth heterologous moiety (H5), the sixth heterologous moiety (H6) are capable of extending the half-life of the FVIII protein.
  • the third heterologous moiety (H3), the fourth heterologous moiety (H4), the fifth heterologous moiety (H5), and the sixth heterologous moiety (H6) are linked to the C terminus or N terminus of FVIII or inserted between two amino acids of FVIII.
  • one or more of the third heterologous moiety (H3), the fourth heterologous moiety (H4), the fifth heterologous moiety (H5), or the sixth heterologous moiety (H6) comprises an amino acid sequence comprising at least about 50 amino acids, at least about 100 amino acids, at least about 150 amino acids, at least about 200 amino acids, at least about 250 amino acids, at least about 300 amino acids, at least about 350 amino acids, at least about 400 amino acids, at least about 450 amino acids, at least about 500 amino acids, at least about 550 amino acids, at least about 600 amino acids, at least about 650 amino acids, at least about 700 amino acids, at least about 750 amino acids, at least about 800 amino acids, at least about 850 amino acids, at least about 900 amino acids, at least about 950 amino acids, or at least about 1000 amino acids.
  • the linker between the FVIII protein and the second heterologous moiety or the linker between the VWF fragment and the first heterologous moiety further comprises a first cleavage site (PI) at the N-terminal region of the linker, a second cleavage site (P2) at the C-terminal region of the linker, or both.
  • PI first cleavage site
  • P2 second cleavage site
  • one or more of the linker between the FVIII protein and the adjunct moiety, the linker between the FVIII protein and the second heterologous moiety, and the linker between the VWF fragment and the first heterologous moiety have a length of about 1 to about 2000 amino acids.
  • the chimeric protein comprises a FVIII protein and an adjunct moiety, which are linked by a linker between the FVIII protein and the adjunct moiety, wherein the linker further comprises a sortase recognition motif, e.g., the sequence of LPXTG (SEQ ID NO: 106 ).
  • the present invention is directed to a von Willebrand Factor (VWF) fragment comprising the D' domain and the D3 domain of VWF, wherein the VWF fragment binds to Factor VIII (FVIII) and inhibits binding of endogenous VWF to a FVIII protein.
  • VWF von Willebrand Factor
  • the VWF fragment of the invention is not amino acids 764 to 1274 of SEQ ID NO: 2.
  • the FVIII protein without the VWF fragment, has a half-life comparable to wild-type FVIII.
  • the FVIII protein is a fusion protein comprising FVIII and a heterologous moiety that is capable of extending half-life of FVIII.
  • the heterologous moiety can be a polypeptide, a non-polypeptide moiety, or both.
  • the heterologous polypeptide moiety can be selected from the group consisting of an immunoglobulin constant region or a portion thereof, albumin or a fragment thereof, an albumin binding moiety, a PAS sequence, a HAP sequence, transferrin or a fragment thereof, and any combination thereof.
  • the heterologous moiety is an immunoglobulin constant region or a portion thereof, e.g., an Fc region.
  • the non-polypeptide moiety is selected from the group consisting of polyethylene glycol (PEG), polysialic acid, hydroxyethyl starch (HES), a derivative thereof, and any combinations thereof.
  • the FVIII protein comprises a first polypeptide chain and a second polypeptide chain, wherein the first polypeptide chain comprises FVIII and a first Fc region and the second polypeptide chain comprises a second Fc region without FVIII.
  • the VWF fragment extends a half-life of FVIII.
  • the amino acid sequence of the D' domain can be at least 90%, 95%, 96%, 97%, 98%, 99%, or 100% identical to amino acids 764 to 866 of SEQ ID NO: 2.
  • the amino acid sequence of the D3 domain can be at least 90%, 95%, 96%, 97%, 98%, 99%, or 100% identical to amino acids 867 to 1240 of SEQ ID NO: 2.
  • the VWF fragment contains at least one amino acid substitution at a residue corresponding to residue 1099, residue 1142, or both of SEQ ID NO: 2.
  • a VWF fragment comprises, consisting essentially of, or consists of amino acids 764 to 1240 of SEQ ID NO: 2.
  • the VWF fragment can further comprise the Dl domain, the D2 domain, or the Dl and D2 domains of VWF.
  • the VWF fragment further comprises a VWF domain selected from the group consisting of the Al domain, the A2 domain, the A3 domain, the D4 domain, the Bl domain, the B2 domain, the B3 domain, the C 1 domain, the C2 domain, the CK domain, one or more fragments thereof, and any combinations thereof.
  • the VWF fragment is pegylated, glycosylated, hesylated, or polysialylated.
  • the present invention is also directed to a chimeric protein comprising a VWF fragment described herein, a heterologous moiety, and an optional linker between the VWF fragment and the heterologous moiety.
  • the heterologous moiety can be a polypeptide, a non-polypeptide moiety, or both.
  • the heterologous polypeptide moiety is selected from the group consisting of an immunoglobulin constant region or a portion thereof, albumin or a fragment thereof, an albumin binding moiety, a PAS sequence, a HAP sequence, transferrin or a fragment thereof, and any combination thereof.
  • the heterologous non-polypeptide moiety is selected from group consisting of polyethylene glycol (PEG), polysialic acid, hydroxyethyl starch (HES), a derivative thereof, and any combinations thereof.
  • the heterologous moiety is a first Fc region.
  • the chimeric protein can further comprise a second Fc region, wherein the second Fc region is linked to or associated with the first Fc region or linked to or associated with the VWF fragment.
  • a chimeric protein of the invention comprises a formula selected from the group consisting of:
  • V is one or more of the VWF fragments described herein, each of LI and L2 is an optional linker;
  • HI is a first heterologous moiety
  • (-) is a peptide bond or one or more amino acids
  • H2 is an optional second heterologous moiety.
  • HI is a first heterologous moiety, e.g., a half-life extending molecule which is known in the art.
  • the first heterologous moiety is a polypeptide.
  • the first heterologous polypeptide moiety is selected from the group consisting of an immunoglobulin constant region or a portion thereof, albumin or a fragment thereof, an albumin binding moiety, a PAS sequence, a HAP sequence, transferrin or a fragment thereof, and any combinations thereof.
  • HI is a non-polypeptide moiety selected from the group consisting of polyethylene glycol (PEG), polysialic acid, hydroxyethyl starch (HES), a derivative thereof, and any combinations thereof.
  • H2 is an optional second heterologous moiety, e.g., a half-life extending molecule which is known in the art.
  • the second heterologous moiety can be selected from the group consisting of an immunoglobulin constant region or a portion thereof, albumin or a fragment thereof, an albumin binding moiety, a PAS sequence, a HAP sequence, transferrin or a fragment thereof, and any combination thereof.
  • H2 is a non-polypeptide moiety, which is selected from the group consisting of polyethylene glycol (PEG), polysialic acid, hydroxyethyl starch (HES), a derivative thereof, and any combinations thereof.
  • PEG polyethylene glycol
  • HES hydroxyethyl starch
  • HI is a first Fc region and H2 is a second Fc region.
  • the first Fc region and the second Fc region can be the same or different and can be linked to each other by a linker or a covalent bond, e.g., a disulfide bond.
  • the second Fc region is linked to or associated with a Factor VIII protein.
  • a third heterologous moiety H3, which is a half-life extender, which is linked to the VWF fragment, the first heterologous moiety, or the second heterologous moiety.
  • the third heterologous moiety can include a polypeptide or a non-polypeptide moiety or both.
  • the third heterologous polypeptide moiety can be selected from the group consisting of an immunoglobulin constant region or a portion thereof, albumin or a fragment thereof, an albumin binding moiety, a PAS sequence, a HAP sequence, transferrin or a fragment thereof, or any combinations thereof.
  • H2 is a non-polypeptide moiety, which is be selected from the group consisting of polyethylene glycol (PEG), polysialic acid, hydroxyethyl starch (HES), a derivative thereof, and any combinations thereof.
  • PEG polyethylene glycol
  • HES hydroxyethyl starch
  • H3 is linked to the VWF fragment or the first or the second heterologous moiety by a cleavable linker, e.g., a thrombin cleavable linker.
  • cleavable linker e.g., a thrombin cleavable linker.
  • the invention provides a chimeric protein comprising a VWF fragment described herein, a FVIII protein, and an optional linker between the VWF fragment and the FVIII protein.
  • the VWF fragment can be bound to the FVIII protein.
  • a chimeric protein comprises a VWF fragment described herein, which is linked to a heterologous moiety.
  • the heterologous moiety can be a moiety that extends the half-life of the protein, which comprises a polypeptide, a non-polypeptide moiety, or both.
  • heterologous polypeptide moiety examples include, e.g., an immunoglobulin constant region or a portion thereof, albumin or a fragment thereof, an albumin binding moiety, a PAS sequence, a HAP sequence, any derivatives or variants thereof, or any combinations thereof.
  • a non-polypeptide moiety examples include, e.g., polyethylene glycol (PEG), polysialic acid, hydroxyethyl starch (HES), a derivative thereof, or any combinations thereof.
  • the heterologous moiety is a first Fc region linked to the VWF fragment.
  • the chimeric protein further comprises a second Fc region linked to the FVIII protein.
  • a chimeric protein comprises a VWF fragment described herein linked to a first heterologous moiety, e.g., first Fc region, and a FVIII protein linked to a second heterologous moiety, e.g., second Fc region, wherein the VWF fragment is further linked to the second heterologous moiety (e.g., second Fc region) or the FVIII protein by a linker or by covalent bond or the first heterologous moiety (e.g., Fc region) is further linked to the FVIII protein or the second heterologous moiety (e.g., second Fc region) by a linker or a covalent bond.
  • the FVIII of the chimeric protein has a partial B-domain.
  • the FVIII protein with a partial B-domain is FVIII198 (SEQ ID NO: 105).
  • the chimeric protein further comprises a sortase recognition motif.
  • the half-life of the FVIII protein is extended compared to a FVIII protein without the VWF fragment or wildtype FVIII.
  • the half-life of the FVIII protein is at least about 1.5 times, at least about 2 times, at least about 2.5 times, at least about 3 times, at least about 4 times, at least about 5 times, at least about 6 times, at least about 7 times, at least about 8 times, at least about 9 times, at least about 10 times, at least about 11 times, or at least about 12 times longer than the half-life of a FVIII protein without the VWF fragment.
  • the half-life of FVIII is about 1.5-fold to about 20-fold, about 1.5 fold to about 15 fold, or about 1.5 fold to about 10 fold longer than the half-life of wild-type FVIII.
  • the half-life of the FVIII is extended about 2-fold to about 10-fold, about 2-fold to about 9-fold, about 2-fold to about 8-fold, about 2-fold to about 7-fold, about 2-fold to about 6- fold, about 2-fold to about 5 -fold, about 2-fold to about 4-fold, about 2-fold to about 3- fold, about 2.5-fold to about 10-fold, about 2.5-fold to about 9-fold, about 2.5-fold to about 8-fold, about 2.5-fold to about 7-fold, about 2.5-fold to about 6-fold, about 2.5-fold to about 5-fold, about 2.5-fold to about 4-fold, about 2.5-fold to about 3-fold, about 3-fold to about 10-fold, about 3-fold to about 9-fold, about 3-fold to about 8-fold, about 3-fold to about 7-fold, about 3 -fold to about 6-
  • the half-life of FVIII is at least about 17 hours, at least about 18 hours, at least about 19 hours, at least about 20 hours, at least about 21 hours, at least about 22 hours, at least about 23 hours, at least about 24 hours, at least about 25 hours, at least about 26 hours, at least about 27 hours, at least about 28 hours, at least about 29 hours, at least about 30 hours, at least about 31 hours, at least about 32 hours, at least about 33 hours, at least about 34 hours, at least about 35 hours, at least about 36 hours, at least about 48 hours, at least about 60 hours, at least about 72 hours, at least about 84 hours, at least about 96 hours, or at least about 108 hours.
  • the half-life of FVIII is about 15 hours to about two weeks, about 16 hours to about one week, about 17 hours to about one week, about 18 hours to about one week, about 19 hours to about one week, about 20 hours to about one week, about 21 hours to about one week, about 22 hours to about one week, about 23 hours to about one week, about 24 hours to about one week, about 36 hours to about one week, about 48 hours to about one week, about 60 hours to about one week, about 24 hours to about six days, about 24 hours to about five days, about 24 hours to about four days, about 24 hours to about three days, or about 24 hours to about two days.
  • the average half-life of the FVIII protein per subject is about 15 hours, about 16 hours, about 17 hours, about 18 hours, about 19 hours, about 20 hours, about 21 hours, about 22 hours, about 23 hours, about 24 hours (1 day), about 25 hours, about 26 hours, about 27 hours, about 28 hours, about 29 hours, about 30 hours, about 31 hours, about 32 hours, about 33 hours, about 34 hours, about 35 hours, about 36 hours, about 40 hours, about 44 hours, about 48 hours (2 days), about 54 hours, about 60 hours, about 72 hours (3 days), about 84 hours, about 96 hours (4 days), about 108 hours, about 120 hours (5 days), about six days, about seven days (one week), about eight days, about nine days, about 10 days, about 11 days, about 12 days, about 13 days, or about 14 days.
  • a chimeric protein of the invention comprises a formula selected from the group consisting of:
  • V is a VWF fragment described herein;
  • each of LI or L2 is an optional linker, e.g., a thrombin cleavable linker;
  • L3 is an optional linker, e.g., scFc linker, e.g., a processable linker; each of HI or H2 is an optional heterologous moiety; and
  • C is a FVIII protein
  • (-) is a peptide bond or one or more amino acids.
  • a chimeric protein of the invention comprises a formula selected from the group consisting of:
  • V is a VWF fragment described herein;
  • each of LI or L2 is an optional linker, e.g., a thrombin cleavable linker;
  • each of HI or H2 is an optional heterologous moiety
  • C is a FVIII protein
  • (-) is a peptide bond or one or more amino acids
  • (:) is a chemical or physical association between HI and H2, between V and C, and between V and HI and C and H2.
  • (:) represents a chemical association, e.g., at least one non-peptide bond.
  • the chemical association, i.e., (:) is a covalent bond.
  • the association between HI and H2 is a covalent bond, e.g., a disulfide bond.
  • the chemical association, i.e., (:) is a non-covalent interaction, e.g., an ionic interaction, a hydrophobic interaction, a hydrophilic interaction, a Van der Waals interaction, a hydrogen bond.
  • the association between the FVIII protein and the VWF fragment is a non- covalent bond.
  • (:) is a non-peptide covalent bond.
  • (:) is a peptide bond.
  • HI is a first heterologous moiety.
  • the first heterologous moiety is capable of extending half- life of the FVIII activity.
  • the first heterologous moiety is a polypeptide, a non-polypeptide moiety, or both.
  • the first heterologous polypeptide moiety can be selected from the group consisting of an immunoglobulin constant region or a portion thereof, albumin or fragment thereof, an albumin binding moiety, a PAS sequence, a HAP sequence, transferrin or a fragment thereof, and any combinations thereof.
  • the non-polypeptide moiety is selected from the group consisting of polyethylene glycol (PEG), polysialic acid, hydroxyethyl starch (HES), a derivative thereof, and any combinations thereof.
  • H2 is a second heterologous moiety.
  • the second heterologous moiety can also be a half-life extender known in the art and can be a polypeptide, a non- polypeptide moiety, or a combination of both.
  • the second heterologous moiety is selected from the group consisting of an immunoglobulin constant region or a portion thereof, albumin or fragment thereof, an albumin binding moiety, a PAS sequence, a HAP sequence, transferrin or a fragment thereof, and any combinations thereof.
  • the non-polypeptide moiety is selected from the group consisting of polyethylene glycol (PEG), polysialic acid, hydroxyethyl starch (HES), a derivative thereof, and any combinations thereof.
  • HI is a first Fc region.
  • H2 is a second Fc region.
  • a third heterologous moiety H3, which is a half- life extender.
  • H3 can be linked to one or more of V, C, HI, or H2 by an optional linker, e.g., a cleavable linker, e.g., a thrombin cleavable linker.
  • a linker e.g., a cleavable linker, e.g., a thrombin cleavable linker.
  • Non-limiting examples of the third heterologous moiety can include an immunoglobulin constant region or a portion thereof, albumin or a fragment thereof, polyethylene glycol (PEG), a PAS sequence, and hydroxyethyl starch (HES) or a derivative thereof.
  • one or more of the linkers used to connect the VWF fragment, the FVIII protein, the first heterologous moiety, and/or the second heterologous moiety of formulas (a) to (u) to each other is a cleavable linker.
  • One or more of the cleavage sites used in the chimeric protein can be cleaved by a protease selected from the group consisting of factor XIa, factor Xlla, kallikrein, factor Vila, factor IXa, factor Xa, factor Ila (thrombin), Elastase-2, Granzyme-B, TEV, Enterokinase, Protease 3C, Sortase A, MMP-12, MMP-13, MMP-17, and MMP-20.
  • one or more linkers used in formulas (a) to (1) comprise a processable linker.
  • the processable linkers can be cleaved by an intracellular enzyme upon secretion.
  • the processable linker can comprise a first cleavage site (PI) at the N-terminal region of the linker, a second cleavage site (P2) at the C-terminal region of the linker, or both.
  • one or more of the linkers used in the invention have a length of at least about 1 to 2000 amino acids. In a specific embodiment, one or more of the linkers used in the invention have a length of at least about 20, 35, 42, 48, 73, 98, 144, 288, 324, 576, or 864 amino acids. In a particular embodiment, one or more of the linkers comprise a gly/ser peptide. The gly/ser peptide can be (Gly4 Ser) 3 or (Gly4 Ser) 4 .
  • a FVIII protein in a chimeric protein is a functional Factor VIII protein.
  • the FVIII protein can comprise one or more domains of FVIII selected from the group consisting of the Al domain, the A2 domain, the B domain, the A3 domain, the CI domain, the C2 domain, one or more fragment thereof, and any combinations thereof.
  • the FVIII protein comprises the B domain or a portion thereof.
  • the FVIII protein is SQ B domain deleted FVIII.
  • the FVIII protein comprises single chain FVIII.
  • the FVIII protein comprises a heavy chain of FVIII and a light chain of Factor VIII, wherein the heavy chain and the light chain are associated with each other by a metal bond.
  • the FVIII protein has a low affinity to or does not bind to a low-density lipoprotein receptor-related protein (LRP).
  • LRP low-density lipoprotein receptor-related protein
  • a FVIII protein useful for the invention can contain at least one amino acid substitution that lowers the affinity to or eliminates the binding to the LRP.
  • Non- limiting examples of the at least one amino acid substitution is at a residue corresponding to residue 471, residue 484, residue 487, residue 490, residue 497, residue 2092, residue 2093 or two or more combinations thereof of full-length mature FVIII.
  • the FVIII protein in a chimeric protein of this invention contains at least one amino acid substitution, which induces the FVIII protein to be more stable than a FVIII protein without the substitution.
  • the FVIII protein contains at least one amino acid substitution in the A2 domain and at least one amino acid substitution in the A3 domain, wherein the A2 domain and the A3 domain are associated to each other by a covalent bond.
  • Non-limiting examples of the amino acid substitution in the A2 domain is at a residue corresponding residue 662 or 664 of full-length mature FVIII.
  • non-limiting examples of the amino acid substitution in the A3 domain is at a residue corresponding to residue 1826 or 1828 of full-length mature FVIII is polysialylated.
  • the invention provides a polynucleotide encoding a VWF fragment described herein or a chimeric protein described herein, or a set of polynucleotides comprising a first nucleotide chain and a second nucleotide chain, wherein the first nucleotide chain encodes the VWF fragment and the second nucleotide chain encodes the second Fc region or the clotting factor or fragment thereof of the chimeric protein.
  • the set of polynucleotides further comprises a third polynucleotide chain, which encodes a proprotein convertase belongs to the subtilisin-like proprotein convertase family.
  • proprotein convertase examples include proprotein convertase subtilisin/kexin type 3 (PACE or PCSK3), proprotein convertase subtilisin/kexin type 5 (PCSK5 or PC5), proprotein convertase subtilisin/kexin type 7 (PCSK7 or PC7), or a yeast Kex 2.
  • the invention includes a vector comprising the polynucleotide or the set of polynucleotides and one or more promoters operably linked to the polynucleotide or the set of polynucleotides or a set of vectors comprising a first vector and a second vector, wherein the first vector encodes the first polynucleotide chain of the set of polynucleotides and the second vector encodes the second polynucleotide chain of the set of polynucleotides.
  • the set of vectors can further comprise a third vector, which comprises a third polynucleotide chain encoding PC5 or PC7.
  • the vector further comprises PACE.
  • PACE cleaves the D1D2 domains of the VWF fragment.
  • the invention is directed to a pharmaceutical composition
  • a pharmaceutical composition comprising the VWF fragment, the chimeric protein, the polynucleotide, the set of polynucleotides, the vector, or the set of vectors, and a pharmaceutically acceptable carrier.
  • the composition of this invention can extend the half-life of Factor VIII.
  • the invention includes a host cell comprising the polynucleotide, the set of polynucleotides, the vector, or the sets of vectors.
  • the present invention is drawn to a chimeric protein comprising a
  • the FVIII protein comprises protecting the FVIII protein from one or more protease cleavages, protecting the FVIII protein from activation, stabilizing the heavy chain and/or the light chain of the FVIII protein, or preventing clearance of the FVIII protein by one or more scavenger receptors.
  • adjunct moiety in the chimeric protein can inhibit or prevent endogenous
  • the VWF binding site is located in the A3 domain or the C2 domain of the FVIII protein or both A3 domain and C2 domain of the FVIII protein.
  • the VWF binding site is the amino acid sequence corresponding to amino acids 1669 to 1689 and 2303 to 2332 of SEQ ID NO: 16.
  • the adjunct moiety is a polypeptide, a non-polypeptide moiety, or both.
  • the polypeptide useful as the adjunct moiety can comprise an amino acid sequence of at least 40, 50, 60, 70, 80, 90, 100, 110, 120, 130, 140, 150, 200, 250, 300, 350, 400, 450, 500, 550, 600, 650, 700, 750, 800, 850, 900, 950, or 1000 amino acids in length.
  • the polypeptide useful as an adjunct moiety can be selected from the group consisting of a VWF fragment, an immunoglobulin constant region or a portion thereof, albumin or a fragment thereof, an albumin binding moiety, a PAS sequence, a HAP sequence, other half-life extending technologies, and any combinations thereof.
  • the non- polypeptide moiety useful as an adjunct moiety can be selected from the group consisting of polyethylene glycol (PEG), polysialic acid, hydroxyethyl starch (HES) or a derivative thereof, and any combinations thereof.
  • the adjunct moiety is the VWF fragment described herein.
  • the adjunct moiety and the FVIII protein can be linked, e.g., by a linker, or associated with each other.
  • the linker can comprise a cleavable linker, e.g., a thrombin cleavable linker.
  • the invention provides a method of preventing or inhibiting binding of a FVIII protein with endogenous VWF comprising adding an effective amount of the VWF fragment, the chimeric protein, the polynucleotide, or the set of polynucleotides to a cell comprising a FVIII protein or a polynucleotide encoding the FVIII protein, wherein the VWF fragment binds to the FVIII protein.
  • the invention includes a method of preventing or inhibiting binding of the FVIII protein with endogenous VWF comprising adding an effective amount of the chimeric protein, the polynucleotide, or the set of polynucleotides to a subject in need thereof, wherein the VWF fragment binds to the FVIII protein and thus prevents or inhibits binding of the FVIII protein.
  • the invention includes a method of extending or increasing half-life of a FVIII protein, wherein the method comprises adding an effective amount of the VWF fragment, the chimeric protein, the polynucleotide, or the set of polynucleotides to a cell comprising a FVIII protein or a polynucleotide encoding the FVIII protein or to a subject in need thereof, wherein the VWF fragment binds to the FVIII protein.
  • the invention is drawn to a method of preventing or inhibiting clearance of a FVIII protein from a cell, wherein the method comprises adding an effective amount of the VWF fragment, the chimeric protein, the polynucleotide, or the set of polynucleotides to a cell comprising a FVIII protein or a polynucleotide encoding the FVIII protein or to a subject in need thereof, wherein the VWF fragment binds to the FVIII protein.
  • the invention is directed to a method of treating a bleeding disease or disorder in a subject in need thereof comprising administering an effective amount of the VWF fragment, the chimeric protein, the polynucleotide , or the set of polynucleotides, wherein the bleeding disease or disorder is selected from the group consisting of a bleeding coagulation disorder, hemarthrosis, muscle bleed, oral bleed, hemorrhage, hemorrhage into muscles, oral hemorrhage, trauma, trauma capitis, gastrointestinal bleeding, intracranial hemorrhage, intra-abdominal hemorrhage, intrathoracic hemorrhage, bone fracture, central nervous system bleeding, bleeding in the retropharyngeal space, bleeding in the retroperitoneal space, and bleeding in the illiopsoas sheath.
  • a bleeding coagulation disorder hemarthrosis
  • muscle bleed oral bleed
  • hemorrhage hemorrhage into muscles
  • oral hemorrhage trauma
  • the treatment is prophylactic or on-demand.
  • the invention is a method of treating a disease or disorder associated with Type 2N von Willebrand's disease to a subject in need thereof, comprising administering an effective amount of the VWF fragment, the chimeric protein, the polynucleotide, or the set of polynucleotides, wherein the disease or disorder is treated.
  • FIG. 1 A shows two VWF fragments containing amino acids 1 to 276 of SEQ ID NO: 73 (amino acids 764 to 1039 of SEQ ID NO: 2).
  • VWF-001 is synthesized without the pre/propeptide sequences of VWF, while VWF-009 is synthesized with the pre/propeptide sequences (Dl and D2 domains).
  • the prepeptide of VWF-009 is cleaved during synthesis, and VWF-009 contains the propeptide with the D' and D3 domain sequences.
  • Fig. 1 A shows two VWF fragments containing amino acids 1 to 276 of SEQ ID NO: 73 (amino acids 764 to 1039 of SEQ ID NO: 2).
  • VWF-001 is synthesized without the pre/propeptide sequences of VWF
  • VWF-009 is synthesized with the pre/propeptide sequences (Dl and D2 domains).
  • the prepeptide of VWF-009 is cleave
  • VWF-002 shows three VWF fragments containing amino acids 1 to 477 of SEQ ID NO: 73 (amino acids 764 to 1240 of SEQ ID NO: 2).
  • VWF-002 is synthesized without the pre/propeptide sequences.
  • VWF-010 contains the D1D2 domains in addition to the D'D3 domains.
  • VWF-013 contains the D1D2DO3 domains in addition to alanine residues substituting cysteines at residues 336 and 379 of SEQ ID NO: 72.
  • Fig. 1C shows two VWF fragments containing the D'D3 domains and a portion of the Al domain.
  • VWF-003 has amino acids 764 to 1274 of SEQ ID NO: 2).
  • VWF-011 contains the D1D2 domains in addition to the D'D3 domains.
  • Fig. ID shows two constructs, VWF-004 and VWF-012.
  • VWF-004 contains the D'D3 domains and the complete sequence of Al domain.
  • VWF-012 contains the D1D2DO3 domains and the complete sequence of Al domain.
  • Fig. IE shows three constructs.
  • VWF-006 contains the D1D2DO3 domains and the CK domain of VWF (cysteine knot domain).
  • VWF-008 is the full-length VWF.
  • VWF-031 (VWF-Fc) shows a construct containing the D1D2DO3 domains linked to a single Fc region by a cleavable linker.
  • VWF-053 is the D1D2 domains.
  • Fig. IF shows full-length VWF protein comprising propeptide (the Dl and D2 domains) and mature subunits (the D', D3, Al, A2, A3, D4, Bl-3, Cl-2 domains).
  • the VWF protein is about 250 kDa protein and forms multimers (> 20 MDa) by disulfide bonding.
  • the VWF protein associates with FVIII (95-98%) in non-covalent complex and then extends half-life of FVIII by protecting FVIII from protease cleavage/activation, stabilizing heavy & light chain, and preventing clearance of FVIII by scavenger receptors.
  • the VWF protein also can limit half-life of FVIII by clearance of FVIII- VWF complex through VWF receptors and preventing pinocytosis and recycling of rFVIIIFc.
  • FIG. 1 Schematic diagrams of examples of VWF:FVIII heterodimer constructs.
  • the left construct shows a VWF fragment having the D'D3 domains of full-length VWF (amino acids 1-477 of SEQ ID NO: 73) and containing alanine substitutions at residues 336 and 379 of SEQ ID NO: 72.
  • the chimeric protein construct (FVIII 064/065) comprises the C-terminus of a VWF fragment linked to a first Fc region by a linker and FVIII is linked to a second Fc region, wherein the second Fc region is further linked to the N-terminus of a VWF fragment by a linker (e.g., formula C-H1-L1-V-L2-H2, wherein V is a VWF fragment, C is FVIII, HI and H2 are Fc regions, and LI and L2 are cleavable linkers).
  • a linker e.g., formula C-H1-L1-V-L2-H2, wherein V is a VWF fragment, C is FVIII, HI and H2 are Fc regions, and LI and L2 are cleavable linkers.
  • the construct in Figure 2b is an intracellularly processed VWF:FVIII heterodimer construct where the linker between the second Fc and the N-terminus of the VWF fragment has been cleaved.
  • FVIII-064 contains the D'D3 domains of VWF (amino acids 1 to 477 of SEQ ID NO: 73 with C336A and C379 substitutions).
  • FVIII-065 contains the D'D3 domains of VWF (amino acids 1 to 276 of SEQ ID NO: 73).
  • FVIII- 136 contains FVIIIFc linked to the D'D3 fragment-Fc by a linker that can be processed by an intracellular protease enzyme.
  • FVIII- 136 When FVIII- 136 is expressed, the enzyme cleaves the linker between the second Fc (fused to FVIII-LC) and the VWF D'D3 fragment (fused to the first Fc), while the Fc region fused to (or linked to) FVIII-LC forms a covalent bond (e.g., a disulfide bond) with the first Fc fused to (or linked to) the VWF fragment.
  • FVIII-148 is single chain FVIIIFc with the D'D3 fragment (a single chain FVIII by introducing R1645A/R1648A mutation into FVIII gene).
  • FIG. 3 Schematic diagrams of examples of VWF:FVIII heterodimer constructs containing examples of variable linkers between VWF and Fc.
  • the constructs (FVIII- 064, FVIII- 159, FVIII- 160, FVIII- 178, and FVIII- 179) have the common structure represented as formula C-H1-L1-V-L2-H2, but contain examples of different linkers or amino acid substitutions.
  • the constructs shown contain the same VWF fragment, which is the D' and D3 domains of VWF (i.e., amino acids 1 to 477 of SEQ ID NO: 73 with amino acid substitutions C336A and C379A).
  • Construct FVIII 64 has a thrombin cleavable linker (i.e., L2) between the VWF fragment and the Fc (i.e., H2), which has 20 amino acids.
  • Construct FVIII 159 has a thrombin cleavable linker (i.e., L2) between the VWF fragment and the Fc (i.e., H2), which has 35 amino acids.
  • Construct FVIII 160 has a thrombin cleavable linker (i.e., L2) between the VWF fragment and the Fc (i.e., H2), which has 48 amino acids.
  • Constructs FVIII-180, FVIII-181, and FVIII-182 are derivatives of FVIII- 160 containing K2092A mutation in FVIII CI domain, K2093A mutation in FVIII CI domain, and K2092A/K2093A mutations in FVIII CI domain, respectively.
  • Construct FVIII-178 has a thrombin cleavable linker (i.e., L2) between the VWF fragment and the Fc (i.e., H2), which has 73 amino acids.
  • Construct FVIII- 179 has a thrombin cleavable linker (i.e., L2) between the VWF fragment and the Fc (i.e., H2), which has 98 amino acids.
  • FIG. 4 Schematic diagrams of examples of FVIII- VWF constructs, in which
  • VWF is D1D2D'D3 fragment of VWF
  • the Linker is a variable length linker containing a cleavage site, e.g., a thrombin cleavage site
  • SC FVIII is a single chain FVIII, which contains the R1645A/R1648A substitutions
  • H is a heterologous moiety, e.g., an immunoglobulin constant region or a portion thereof, a moiety for conjugating polyethylene glycol (PEG) and/or PEG, an albumin or albumin fragment, an albumin binding moiety, a HAP sequence, a moiety for polysialylation and/or polysialic acid, a moiety for hydroxyethyl starch (HES) and/or HES, or a PAS sequence, etc.
  • HC FVIII is a heavy chain of FVIII
  • LC FVIII is a light chain of FVIII
  • Fc is an Fc region of an immunoglob
  • Figure 4A has a formula of VWF-Linker-SC FVIII.
  • Figure 4B has a formula of VWF-Linker-H-Linker-SC FVIII.
  • the linkers (the first linker between VWF and H and the second linker between H and SC FVIII) can be identical or different.
  • Figure 4C has a formula of VWF-Linker-SC FVIII-Linker-H.
  • the linkers (the first linker between VWF and SC FVIII and the second linker between SC FVIII and H) can be identical or different.
  • Figure 4D has a formula of VWF-Linker-HC FVIII-H- Linker-LC FVIII.
  • the linkers (the first linker between VWF and HC FVIII and the second linker between H and LC FVIII) can be identical or different.
  • Figure 4E has a formula of HC FVIII-H-LC FVIII-Linker-first Fc-Linker-VWF-Linker-second Fc.
  • the linkers (the first linker between LC FVIII and first Fc, the second linker between first Fc and VWF, and the third linker between VWF and second Fc) can be identical or different.
  • the linkers can be a cleavable linker.
  • the linker between first Fc and VWF can be a cleavable linker comprising a cleavage site at the N-terminus and/or the C- terminus of the linker.
  • the first Fc and the second Fc can be identical or different.
  • Figure 4F has a formula of HC FVIII-H-LC FVIII-Linker-first Fc-Linker-VWF-Linker-second Fc.
  • the linkers (the first linker between LC FVIII and first Fc, the second linker between first Fc and VWF, and the third linker between VWF and second Fc) can be identical or different.
  • One or more linkers can be a cleavable linker.
  • the linker between the first Fc and VWF can be a cleavable linker comprising a cleavage site at the N- terminus and/or the C-terminus of the linker.
  • the first Fc and the second Fc can be identical or different.
  • Figure 4G has a formula of SC FVIII-Linker-Fc-Linker-VWF-H- Linker-Fc.
  • Figure 4H has a formula of Pegylated or Hesylated SC FVIII-Linker-Fc- Linker-VWF-H-Linker-Fc.
  • the linkers (the first linker between SC FVIII and first Fc, the second linker between first Fc and VWF, and the third linker between H and second Fc) can be identical or different.
  • One or more linkers can be a cleavable linker.
  • the linker between the first Fc and VWF can be a cleavable linker comprising a cleavage site at the N-terminus and/or the C-terminus of the linker.
  • the first Fc and the second Fc can be identical or different.
  • Figure 5 Schematic diagrams of FVIII-VWF heterodimer co-transfection system.
  • Construct FVIII- 155 contains the full-length FVIII sequence (with an alanine residue substituting the arginine residues at 1645 and 1648) linked to an Fc region.
  • VWF-031 contains the D1D2D'D3 fragment (with an alanine residue substituting the Cysteine residues at 336 and 379) which is linked to another Fc region with a 48 thrombin cleavable linker.
  • construct FVIII- 155 produces a full length single chain FVIII (SCFVIII) fused to one Fc fragment
  • construct VWF-031 produces a 477 amino acids D'D3 fragment linked to another Fc fragment. Two covalent bonds can be formed between the Fc fragments that are linked to the SC FVIII or the D'D3 fragment, this in turn allows a covalent association of FVIII and D'D3, which is the main character of the desired final product.
  • Figure 6 is the non-reducing and reducing SDS PAGE of VWF-009 (D1D2D'D3
  • FIG. 7 is the non-reducing and reducing SDS PAGE of VWF-002 (D'D3 1-477 aa x 6 his) or VWF-010 (D1D2D'D3 1-477 aa x 6 his), which shows VWF-002 exists as a monomer and VWF-010 exists as a dimer.
  • Figure 8 shows thrombin digestion of FVIII- VWF heterodimer shown in Figure
  • Lane 1 shows marker. Lane 2 is rFVIII-Fc without thrombin. Lane 3 is rFVIII-Fc with thrombin. Lane 5 is FVIIIFc-VWF. Lane 6 shows FVIIIFc-VWF and thrombin. Al indicates Al domain of FVIII, A2 indicates A2 domain of FVIII, and Aa3 LC indicates the light chain of FVIII.
  • Figure 9A-B shows the FVIII activity measured by a FVIII chromogenic assay.
  • Fig. 9A shows pharmacokinetic profile of rFVIII and rFVIIIFc in HemA mouse.
  • Fig. 9B shows PK profile of rFVIII and rFVIIIFc in FVIII/VWF Double knockout (DKO) mouse.
  • the Y axis shows FVIII activity in mlU/mL, and the X axis shows time.
  • FIG 10A-B shows FVIII protection by the D'D3 fragments as shown by mFVIII plasma level (mlU/mL) and VWF expression level (nM/mL) 48 hours post plasmid injection.
  • the VWF fragments used to show FVIII protection are VWF-001 (276aa, monomer), VWF-009 (276aa, monomer), VWF-002 (477aa, monomer), VWF- 010 (477aa,dimer), VWF-003 (511aa, monomer), VWF-011 (511aa, dimer), VWF-004 (716aa, monomer), VWF-012 (716aa, dimer), VWF-006, and VWF-008.
  • Figure 11 shows the pharmacokinetic profile of rBDD-FVIII in FVIII-VWF DKO mice when co-administered with D'D3 fragments.
  • Figure 11A shows FVIII activity (mlU/mL) measured by a FVIII chromogenic assay after co-administration of rBDD- FVIII and VWF-002 or rBDD-FVIII and VWF-010 or rBDD-FVIII alone in FVIII/VWF DKO mice.
  • Fig. 11B shows VWF-002 and VWF-010 plasma level (ng/mL) after administration.
  • the X axis represents time in hours.
  • Figure 12 shows pharmacokinetic profile of rFVIIIFc in VWF D'D3 expressing mice.
  • Figure 12A shows the timeline of hydrodynamic injection (HDI) of the D'D3 domain encoding plasmid DNA (day -5), intravenous dosing of rFVIIIFc (day 0), and PK sample collection (dayO - day3).
  • HDI hydrodynamic injection
  • Figure 12B shows post rFVIIIFc infusion plasma FVIII activity (mlU/mL) measured by a FVIII chromogenic assay in FVIII/VWF DKO mice with HDI of the D1D2DO3 domains (477aa) (circle) and the D1D2DO3 domains (477aa) with cysteine substitutions (rectangle) in FVIII/VWF DKO mice.
  • the FVIII activity in control mice without HDI of the D'D3 domains is shown as triangle.
  • Fig. IOC show the D'D3 plasma level (ng/mL) after HDI administration of the D1D2D'D3 dimer or the D1D2D'D3 monomer DNA construct.
  • the X axis represents time in hours.
  • Figure 13 shows D'D3-Fc linker selection by HDI in FVIII/VWF DKO mice.
  • Figure 14 shows HDI of Single Chain FVIIIFc/D'D3 heterodimer in FVIII/VWF
  • Figure 15 shows binding affinity of FVIII-155/VWF-031 heterodimer to immobilized hVWF by Octet assay.
  • FVIIIFc, FVIII, and IgG were also used as controls.
  • the x-axis shows time in seconds
  • the y-axis shows the binding in nanometer (nm).
  • Figure 16 shows FVIII-155/VWF-031 pharmacokinetics in FVIII/VWF deficient
  • mice (FVIII/VWF DKO) mice.
  • the x-axis indicates time in hours, and the y-axis indicates FVIII recovery v. input in percent.
  • FIG. 17 Schematic diagrams of examples of VWF fragment constructs, in which VWF is D1D2DO3 fragment of VWF; the Linker is a variable length linker containing a cleavage site, e.g., a thrombin cleavage site; H is a heterologous moiety, e.g., an immunoglobulin constant region or a portion thereof, a moiety for conjugating polyethylene glycol (PEG) and/or PEG, an albumin or albumin fragment, an albumin binding moiety, a HAP sequence, a moiety for polysialylation and/or polysialic acid, a moiety for hydroxyethyl starch (HES) and/or HES, or a PAS sequence, etc.; and Fc is an Fc region of an immunoglobulin.
  • PEG polyethylene glycol
  • HAP sequence a moiety for polysialylation and/or polysialic acid
  • HES hydroxyethyl star
  • Figure 17A has a formula of D1D2-D 'partial D3-H- Partial D3-Linker-Fc.
  • Figure 17B has a formula of D1D2-Partial D'-H- partial D'D3- Linker-Fc.
  • Figure 17C has a formula of D1D2-Pegylated or Hesylated D'D3- Linker-Fc.
  • the linker can be optionally cleaved.
  • Figure 18 A) shows FVIIIFc loses FVIII activity in both HemA (diamond) and
  • DKO square plasma over time.
  • FVIII activity is measured by chromogenic assay.
  • X- axis shows time in hours, and y-axis shows relative activity.
  • B) shows that the loss in FVIII activity is due to the dissociation or degradation of the heavy chain (HC).
  • the left panel shows an immuno-precipitation assay using sheep anti-FVIII polyclonal antibody in Bio-rad 4-15% gel. The gel was reduced and imaged by Bio-rad system.
  • Lane 1 shows Bio-rad unstain marker;
  • lane 2 shows FVIIIFc and PBS;
  • lane 3 shows FVIIIFc and DKO plasma; and
  • lane 5 shows sheep anti-FVIII polyclonal antibody alone.
  • the right panel shows Western analysis of the gel using FVIII anti-heavy chain antibody (GMA012).
  • Lane 1 shows Bio-rad unstain marker;
  • lane 2 shows FVIIIFc and PBS;
  • lane 3 shows FVIIIFc and DKO plasma; and
  • lane 4 shows sheep anti-FVIII polyclonal antibody alone.
  • Figure 19 shows FVIII activity of wild type FVIIIFc (circle), scFVIIIFc (single chain FVIII) (filled triangle), or FVIILVWF heterodimer (e.g., FVIII155/VWF31) (empty triangle) by chromogenic assay in DKO mouse plasma (left panel) and HemA mouse plasma (right panel) as a function of time.
  • Y axis shows relative FVIII activity.
  • Wild type FVIIIFc contains dual chain of FVIII (i.e., FVIII heavy chain and FVIII light chain held together non-covalently) and thus has three chains, a FVIII heavy chain, a FVIII light chain fused to an Fc, and an Fc alone.
  • ScFVIIIFc contains a FVIII single chain and thus has two chains, one with a single chain FVIII fused to an Fc and another with an Fc alone.
  • the FVIILVWF heterodimer e.g., FVIII 155 /VWF031) contains single chain FVIII fused to an Fc and a VWF fragment (D'D3) fused to an Fc.
  • FIG 20 shows processing of D1D2 domain from VWF fragment (e.g., VWF-
  • Figure 21 shows that a binding assay of a FVIILVWF heterodimer (e.g.,
  • FVIII- 155 /VWF-031) by ForteBio octet instrument.
  • full length VWF was captured by using APS sensor.
  • the binding of FVIIIFc and FVIII to the full-length VWF is shown at the lower left panel.
  • the lack of binding of FVIIIY1680 (a mutant having no affinity for VWF) and FVIILVWF heterodimer (FVIII155/VWF031) is shown at the lower right panel.
  • B) shows another binding assay of a FVIILVWF heterodimer (e.g., FVIII-155/VWF-031).
  • the constructs VWF031 construct, FVIII- 155/VWF031, or FVIII
  • the binding of the constructs to FVIII was measured.
  • Figure 22 shows binding affinity of VWF D'D3 domains with FVIII molecule measured by a surface plasma resonance experiment.
  • the VWF031 construct (100RU) was captured by 1000RU anti-human IgG.
  • B-domain deleted FVIII was applied in single cycle kinetics mode in 1 : 1 fit. The total number was 4.
  • Figure 23 shows effects of different linker length in the FVIIIFc/VWF heterodimer constructs on pharmacokinetics when administered in FVIII/VWF DKO mice.
  • Three different linkers 48 aa, 73aa, or 98aa) were inserted between the D'D3 and the Fc, i.e., VWF031, VWF035, and VWF036.
  • the FVIII activity normalized to 5 min value (%) is shown in Y-axis.
  • Figure 24 shows examples of sortase ligation of a VWF fragment with FVIII.
  • A) shows two ligation constructs, (1) a VWF fragment fused to a sortase recognition motif (e.g., LPXTG) at the C-terminus and (2) FVIII having glycine (n) at the N-terminus. After reaction with sortase, the VWF fragment and the sortase recognition motif are ligated to the N-terminus of FVIII.
  • B) shows two ligation constructs, (1) FVIII fused to a sortase recognition motif at its C-terminus and (2) a VWF fragment having glycine (n) at its N-terminus.
  • FVIII and the sortase recognition motif are fused to the VWF fragment at the N-terminus of the VWF fragment.
  • C) shows two ligation constructs, (1) a VWF fragment fused to a sortase recognition motif by a variable length linker and (2) FVIII fused to glycine (n) at its N-terminus.
  • the VWF fused by a linker to the sortase recognition motif is ligated to the N- terminus of FVIII.
  • D) shows two ligation constructs, (1) FVIII fused by a variable length linker to a sortase recognition motif and (2) a VWF fragment fused to glycine (n) at its N- terminus.
  • FVIII fused by a linker to the sortase recognition motif is ligated to the N terminus of VWF fragment.
  • E) shows a ligation construct containing a VWF fragment fused by a variable length linker to a sortase recognition motif, which is also fused to a protease cleavage site (e.g., Thrombin cleavage site) fused by a variable length linker to an Fc.
  • a protease cleavage site e.g., Thrombin cleavage site
  • FIG. 25 shows a schematic comparison of FVIII155 and FVIII198.
  • FVIII155 encodes a single chain FVIIIFc protein.
  • FVIII 198 is a partial B-domain containing single chain FVIIIFc molecule-226N6. 226 represents the N-terminus 226 amino acid of the FVIII B-domain, and N6 represents six N-glycosylation sites in the B-domain.
  • Figure 26 A) shows a stability assay measuring the relativity activity of FVIII 155 and FVIII 198 in DKO plasma as a function of time.
  • the presence of the partial B-domain in FVIII 198 increased the stability of single chain FVIIIFc in comparison to FVIII155;
  • B) shows a comparison of the half-lives of FVIII198, FVIII 155, and dual chain (dcFVIIIFc) in DKO mice.
  • single chain FVIII FVIII 155) has a 1.5 fold increase in half life in comparison to dual chain FVIII.
  • Single chain FVIII with the 266N6 B-domain (FVIII 198) had a further 1.5 fold increase in half life.
  • the graph shows the FVIII recovery v. the 5 minute value (%) as a function of time.
  • a or “an” entity refers to one or more of that entity; for example, “a nucleotide sequence,” is understood to represent one or more nucleotide sequences.
  • the terms “a” (or “an”), “one or more,” and “at least one” can be used interchangeably herein.
  • polynucleotide or “nucleotide” is intended to encompass a singular nucleic acid as well as plural nucleic acids, and refers to an isolated nucleic acid molecule or construct, e.g., messenger RNA (mRNA) or plasmid DNA (pDNA).
  • a polynucleotide comprises a conventional phosphodiester bond or a non- conventional bond (e.g., an amide bond, such as found in peptide nucleic acids (PNA)).
  • PNA peptide nucleic acids
  • nucleic acid refers to any one or more nucleic acid segments, e.g., DNA or RNA fragments, present in a polynucleotide.
  • isolated nucleic acid or polynucleotide is intended a nucleic acid molecule, DNA or RNA, which has been removed from its native environment.
  • a recombinant polynucleotide encoding a Factor VIII polypeptide contained in a vector is considered isolated for the purposes of the present invention.
  • Further examples of an isolated polynucleotide include recombinant polynucleotides maintained in heterologous host cells or purified (partially or substantially) from other polynucleotides in a solution.
  • Isolated RNA molecules include in vivo or in vitro RNA transcripts of polynucleotides of the present invention.
  • Isolated polynucleotides or nucleic acids according to the present invention further include such molecules produced synthetically.
  • a polynucleotide or a nucleic acid can include regulatory elements such as promoters, enhancers, ribosome binding sites, or transcription termination signals.
  • a "coding region” or “coding sequence” is a portion of polynucleotide which consists of codons translatable into amino acids. Although a “stop codon” (TAG, TGA, or TAA) is typically not translated into an amino acid, it may be considered to be part of a coding region, but any flanking sequences, for example promoters, ribosome binding sites, transcriptional terminators, introns, and the like, are not part of a coding region.
  • coding region typically determined by a start codon at the 5' terminus, encoding the amino terminus of the resultant polypeptide, and a translation stop codon at the 3 'terminus, encoding the carboxyl terminus of the resulting polypeptide.
  • Two or more coding regions of the present invention can be present in a single polynucleotide construct, e.g., on a single vector, or in separate polynucleotide constructs, e.g., on separate (different) vectors.
  • a single vector can contain just a single coding region, or comprise two or more coding regions, e.g., a single vector can separately encode a binding domain-A and a binding domain-B as described below.
  • a vector, polynucleotide, or nucleic acid of the invention can encode heterologous coding regions, either fused or unfused to a nucleic acid encoding a binding domain of the invention.
  • Heterologous coding regions include without limitation specialized elements or motifs, such as a secretory signal peptide or a heterologous functional domain.
  • Certain proteins secreted by mammalian cells are associated with a secretory signal peptide which is cleaved from the mature protein once export of the growing protein chain across the rough endoplasmic reticulum has been initiated.
  • signal peptides are generally fused to the N- terminus of the polypeptide, and are cleaved from the complete or "full-length" polypeptide to produce a secreted or "mature" form of the polypeptide.
  • a native signal peptide e.g., an immunoglobulin heavy chain or light chain signal peptide is used, or a functional derivative of that sequence that retains the ability to direct the secretion of the polypeptide that is operably associated with it.
  • a heterologous mammalian signal peptide e.g., a human tissue plasminogen activator (TP A) or mouse B-glucuronidase signal peptide, or a functional derivative thereof, can be used.
  • downstream refers to a nucleotide sequence that is located 3' to a reference nucleotide sequence.
  • downstream nucleotide sequences relate to sequences that follow the starting point of transcription. For example, the translation initiation codon of a gene is located downstream of the start site of transcription.
  • upstream refers to a nucleotide sequence that is located 5' to a reference nucleotide sequence.
  • upstream nucleotide sequences relate to sequences that are located on the 5' side of a coding region or starting point of transcription. For example, most promoters are located upstream of the start site of transcription.
  • regulatory region refers to nucleotide sequences located upstream (5' non-coding sequences), within, or downstream (3' non-coding sequences) of a coding region, and which influence the transcription, RNA processing, stability, or translation of the associated coding region. Regulatory regions may include promoters, translation leader sequences, introns, polyadenylation recognition sequences, RNA processing sites, effector binding sites and stem-loop structures. If a coding region is intended for expression in a eukaryotic cell, a polyadenylation signal and transcription termination sequence will usually be located 3' to the coding sequence.
  • a polynucleotide which encodes a gene product can include a promoter and/or other transcription or translation control elements operably associated with one or more coding regions.
  • a coding region for a gene product e.g., a polypeptide
  • a coding region and a promoter are "operably associated" if induction of promoter function results in the transcription of mRNA encoding the gene product encoded by the coding region, and if the nature of the linkage between the promoter and the coding region does not interfere with the ability of the promoter to direct the expression of the gene product or interfere with the ability of the DNA template to be transcribed.
  • Other transcription control elements besides a promoter, for example enhancers, operators, repressors, and transcription termination signals, can also be operably associated with a coding region to direct gene product expression.
  • transcription control regions which function in vertebrate cells, such as, but not limited to, promoter and enhancer segments from cytomegaloviruses (the immediate early promoter, in conjunction with intron-A), simian virus 40 (the early promoter), and retroviruses (such as Rous sarcoma virus).
  • Other transcription control regions include those derived from vertebrate genes such as actin, heat shock protein, bovine growth hormone and rabbit ⁇ -globin, as well as other sequences capable of controlling gene expression in eukaryotic cells. Additional suitable transcription control regions include tissue-specific promoters and enhancers as well as lymphokine-inducible promoters (e.g., promoters inducible by interferons or interleukins).
  • translation control elements include, but are not limited to ribosome binding sites, translation initiation and termination codons, and elements derived from picomaviruses (particularly an internal ribosome entry site, or IRES, also referred to as a CITE sequence).
  • RNA messenger RNA
  • tRNA transfer RNA
  • shRNA small hairpin RNA
  • siRNA small interfering RNA
  • expression produces a "gene product.”
  • a gene product can be either a nucleic acid, e.g., a messenger RNA produced by transcription of a gene, or a polypeptide which is translated from a transcript.
  • Gene products described herein further include nucleic acids with post transcriptional modifications, e.g. , polyadenylation or splicing, or polypeptides with post translational modifications, e.g., methylation, glycosylation, the addition of lipids, association with other protein subunits, or proteolytic cleavage.
  • post transcriptional modifications e.g. , polyadenylation or splicing
  • polypeptides with post translational modifications e.g., methylation, glycosylation, the addition of lipids, association with other protein subunits, or proteolytic cleavage.
  • a "vector” refers to any vehicle for the cloning of and/or transfer of a nucleic acid into a host cell.
  • a vector may be a replicon to which another nucleic acid segment may be attached so as to bring about the replication of the attached segment.
  • a "replicon” refers to any genetic element (e.g., plasmid, phage, cosmid, chromosome, virus) that functions as an autonomous unit of replication in vivo, i.e., capable of replication under its own control.
  • the term “vector” includes both viral and nonviral vehicles for introducing the nucleic acid into a cell in vitro, ex vivo or in vivo.
  • Plasmids A large number of vectors are known and used in the art including, for example, plasmids, modified eukaryotic viruses, or modified bacterial viruses. Insertion of a polynucleotide into a suitable vector can be accomplished by ligating the appropriate polynucleotide fragments into a chosen vector that has complementary cohesive termini.
  • Vectors may be engineered to encode selectable markers or reporters that provide for the selection or identification of cells that have incorporated the vector. Expression of selectable markers or reporters allows identification and/or selection of host cells that incorporate and express other coding regions contained on the vector.
  • selectable marker genes known and used in the art include: genes providing resistance to ampicillin, streptomycin, gentamycin, kanamycin, hygromycin, bialaphos herbicide, sulfonamide, and the like; and genes that are used as phenotypic markers, i.e., anthocyanin regulatory genes, isopentanyl transferase gene, and the like.
  • reporters known and used in the art include: luciferase (Luc), green fluorescent protein (GFP), chloramphenicol acetyltransferase (CAT), -galactosidase (LacZ), -glucuronidase (Gus), and the like. Selectable markers may also be considered to be reporters.
  • Plasmid refers to an extra-chromosomal element often carrying a gene that is not part of the central metabolism of the cell, and usually in the form of circular double-stranded DNA molecules.
  • Such elements may be autonomously replicating sequences, genome integrating sequences, phage or nucleotide sequences, linear, circular, or supercoiled, of a single- or double-stranded DNA or RNA, derived from any source, in which a number of nucleotide sequences have been joined or recombined into a unique construction which is capable of introducing a promoter fragment and DNA sequence for a selected gene product along with appropriate 3' untranslated sequence into a cell.
  • Eukaryotic viral vectors that can be used include, but are not limited to, adenovirus vectors, retrovirus vectors, adeno-associated virus vectors, poxvirus, e.g., vaccinia virus vectors, baculovirus vectors, or herpesvirus vectors.
  • Non-viral vectors include plasmids, liposomes, electrically charged lipids (cytofectins), DNA-protein complexes, and biopolymers.
  • a "cloning vector” refers to a "replicon,” which is a unit length of a nucleic acid that replicates sequentially and which comprises an origin of replication, such as a plasmid, phage or cosmid, to which another nucleic acid segment may be attached so as to bring about the replication of the attached segment.
  • Certain cloning vectors are capable of replication in one cell type, e.g., bacteria and expression in another, e.g., eukaryotic cells.
  • Cloning vectors typically comprise one or more sequences that can be used for selection of cells comprising the vector and/or one or more multiple cloning sites for insertion of nucleic acid sequences of interest.
  • expression vector refers to a vehicle designed to enable the expression of an inserted nucleic acid sequence following insertion into a host cell.
  • the inserted nucleic acid sequence is placed in operable association with regulatory regions as described above.
  • Vectors are introduced into host cells by methods well known in the art, e.g., transfection, electroporation, microinjection, transduction, cell fusion, DEAE dextran, calcium phosphate precipitation, lipofection (lysosome fusion), use of a gene gun, or a DNA vector transporter.
  • Culture means to incubate cells under in vitro conditions that allow for cell growth or division or to maintain cells in a living state.
  • Cultured cells means cells that are propagated in vitro.
  • polypeptide is intended to encompass a singular
  • polypeptide as well as plural “polypeptides,” and refers to a molecule composed of monomers (amino acids) linearly linked by amide bonds (also known as peptide bonds).
  • polypeptide refers to any chain or chains of two or more amino acids, and does not refer to a specific length of the product.
  • peptides, dipeptides, tripeptides, oligopeptides, "protein,” “amino acid chain,” or any other term used to refer to a chain or chains of two or more amino acids are included within the definition of "polypeptide,” and the term “polypeptide” can be used instead of, or interchangeably with any of these terms.
  • polypeptide is also intended to refer to the products of post-expression modifications of the polypeptide, including without limitation glycosylation, acetylation, phosphorylation, amidation, derivatization by known protecting/blocking groups, proteolytic cleavage, or modification by non-naturally occurring amino acids.
  • a polypeptide can be derived from a natural biological source or produced recombinant technology, but is not necessarily translated from a designated nucleic acid sequence. It can be generated in any manner, including by chemical synthesis.
  • an "isolated" polypeptide or a fragment, variant, or derivative thereof refers to a polypeptide that is not in its natural milieu. No particular level of purification is required. For example, an isolated polypeptide can simply be removed from its native or natural environment. Recombinantly produced polypeptides and proteins expressed in host cells are considered isolated for the purpose of the invention, as are native or recombinant polypeptides which have been separated, fractionated, or partially or substantially purified by any suitable technique.
  • fragments or variants of polypeptides are also included in the present invention.
  • fragments or variants of polypeptides include any polypeptides which retain at least some of the properties (e.g., FcRn binding affinity for an FcRn binding domain or Fc variant, coagulation activity for an FVIII variant, or FVIII binding activity for the VWF fragment) of the reference polypeptide.
  • Fragments of polypeptides include proteolytic fragments, as well as deletion fragments, in addition to specific antibody fragments discussed elsewhere herein, but do not include the naturally occurring full-length polypeptide (or mature polypeptide).
  • Variants of polypeptide binding domains or binding molecules of the present invention include fragments as described above, and also polypeptides with altered amino acid sequences due to amino acid substitutions, deletions, or insertions. Variants can be naturally or non-naturally occurring. Non-naturally occurring variants can be produced using art-known mutagenesis techniques. Variant polypeptides can comprise conservative or non- conservative amino acid substitutions, deletions or additions.
  • VWF fragment or "VWF fragments” used herein means any VWF fragments that interact with FVIII and retain at least one or more properties that are normally provided to FVIII by full-length VWF, e.g., preventing premature activation to FVIIIa, preventing premature proteolysis, preventing association with phospholipid membranes that could lead to premature clearance, preventing binding to FVIII clearance receptors that can bind naked FVIII but not VWF-bound FVIII, and/or stabilizing the FVIII heavy chain and light chain interactions.
  • VWF fragment does not include full length-or mature VWF protein.
  • the "VWF fragment" as used herein comprises a D' domain and a D3 domain of the VWF protein, but does not include the Al domain, the A2 domain, the A3 domain, the D4 domain, the Bl domain, the B2 domain, the B3 domain, the CI domain, the C2 domain, and the CK domain of the VWF protein.
  • half-life limiting factor or "FVIII half-life limiting factor” as used herein indicates a factor that prevents the half-life of a FVIII protein from being longer than 1.5 fold or 2 fold compared to wild-type FVIII (e.g., ADVATE® or REFACTO®).
  • full length or mature VWF can act as a FVIII half-life limiting factor by inducing the FVIII and VWF complex to be cleared from system by one or more VWF clearance pathways.
  • endogenous VWF is a FVIII half-life limiting factor.
  • a full-length recombinant VWF molecule non-covalently bound to a FVIII protein is a FVIII-half-life limiting factor.
  • endogenous VWF indicates VWF molecules naturally present in plasma.
  • the endogenous VWF molecule can be multimer, but can be a monomer or a dimer. Endogenous VWF in plasma binds to FVIII and forms a non- covalent complex with FVIII.
  • a "conservative amino acid substitution” is one in which the amino acid residue is replaced with an amino acid residue having a similar side chain.
  • Families of amino acid residues having similar side chains have been defined in the art, including basic side chains (e.g., lysine, arginine, histidine), acidic side chains (e.g., aspartic acid, glutamic acid), uncharged polar side chains (e.g., glycine, asparagine, glutamine, serine, threonine, tyrosine, cysteine), nonpolar side chains (e.g., alanine, valine, leucine, isoleucine, proline, phenylalanine, methionine, tryptophan), beta-branched side chains (e.g., threonine, valine, isoleucine) and aromatic side chains (e.g., tyrosine, phenylalanine, tryptophan, histidine).
  • basic side chains e
  • a string of amino acids can be conservatively replaced with a structurally similar string that differs in order and/or composition of side chain family members.
  • sequence identity between two polypeptides is determined by comparing the amino acid sequence of one polypeptide to the sequence of a second polypeptide.
  • sequence identity is determined by comparing the amino acid sequence of one polypeptide to the sequence of a second polypeptide.
  • whether any particular polypeptide is at least about 50%, 60%, 70%, 75%, 80%, 85%, 90%, 95%, 99%, or 100% identical to another polypeptide can be determined using methods and computer programs/software known in the art such as, but not limited to, the BESTFIT program (Wisconsin Sequence Analysis Package, Version 8 for Unix, Genetics Computer Group, University Research Park, 575 Science Drive, Madison, WI 53711).
  • BESTFIT uses the local homology algorithm of Smith and Waterman, Advances in Applied Mathematics 2:482-489 (1981), to find the best segment of homology between two sequences.
  • the parameters are set, of course, such that the percentage of identity is calculated over the full-length of the reference polypeptide sequence and that gaps in homology of up to 5% of the total number of amino acids in the reference sequence are allowed.
  • an "amino acid corresponding to" or an "equivalent amino acid" in a VWF sequence or a FVIII protein sequence is identified by alignment to maximize the identity or similarity between a first VWF or FVIII sequence and a second VWF or FVIII sequence.
  • the number used to identify an equivalent amino acid in a second VWF or FVIII sequence is based on the number used to identify the corresponding amino acid in the first VWF or FVIII sequence.
  • a "fusion" or “chimeric” protein comprises a first amino acid sequence linked to a second amino acid sequence with which it is not naturally linked in nature.
  • the amino acid sequences which normally exist in separate proteins can be brought together in the fusion polypeptide, or the amino acid sequences which normally exist in the same protein can be placed in a new arrangement in the fusion polypeptide, e.g., fusion of a Factor VIII domain of the invention with an immunoglobulin Fc domain.
  • a fusion protein is created, for example, by chemical synthesis, or by creating and translating a polynucleotide in which the peptide regions are encoded in the desired relationship.
  • a chimeric protein can further comprises a second amino acid sequence associated with the first amino acid sequence by a covalent, non-peptide bond or a non-covalent bond.
  • half-life refers to a biological half-life of a particular polypeptide in vivo.
  • Half-life may be represented by the time required for half the quantity administered to a subject to be cleared from the circulation and/or other tissues in the animal.
  • a clearance curve of a given polypeptide is constructed as a function of time, the curve is usually biphasic with a rapid a-phase and longer ⁇ -phase.
  • the a-phase typically represents an equilibration of the administered Fc polypeptide between the intra- and extra-vascular space and is, in part, determined by the size of the polypeptide.
  • the ⁇ - phase typically represents the catabolism of the polypeptide in the intravascular space.
  • FVIII and chimeric proteins comprising FVIII are monophasic, and thus do not have an alpha phase, but just the single beta phase. Therefore, in certain embodiments, the term half-life as used herein refers to the half-life of the polypeptide in the ⁇ -phase. The typical ⁇ phase half-life of a human antibody in humans is 21 days.
  • heterologous as applied to a polynucleotide or a polypeptide, means that the polynucleotide or polypeptide is derived from a distinct entity from that of the entity to which it is being compared. Therefore, a heterologous polypeptide linked to a VWF fragment means a polypeptide chain that is linked to a VWF fragment and is not a naturally occurring part of the VWF fragment. For instance, a heterologous polynucleotide or antigen can be derived from a different species, different cell type of an individual, or the same or different type of cell of distinct individuals.
  • linked refers to a first amino acid sequence or nucleotide sequence covalently or non-covalently joined to a second amino acid sequence or nucleotide sequence, respectively.
  • covalently linked or “covalent linkage” refers to a covalent bond, e.g., a disulfide bond, a peptide bond, or one or more amino acids, e.g., a linker, between the two moieties that are linked together.
  • the first amino acid or nucleotide sequence can be directly joined or juxtaposed to the second amino acid or nucleotide sequence or alternatively an intervening sequence can covalently join the first sequence to the second sequence.
  • the term "linked" means not only a fusion of a first amino acid sequence to a second amino acid sequence at the C-terminus or the N- terminus, but also includes insertion of the whole first amino acid sequence (or the second amino acid sequence) into any two amino acids in the second amino acid sequence (or the first amino acid sequence, respectively).
  • the first amino acid sequence can be joined to a second amino acid sequence by a peptide bond or a linker.
  • the first nucleotide sequence can be joined to a second nucleotide sequence by a phosphodiester bond or a linker.
  • the linker can be a peptide or a polypeptide (for polypeptide chains) or a nucleotide or a nucleotide chain (for nucleotide chains) or any chemical moiety (for both polypeptide and polynucleotide chains).
  • the covalent linkage is sometimes indicated as (-) or hyphen.
  • the term "associated with” refers to a covalent or non-covalent bond formed between a first amino acid chain and a second amino acid chain. In one embodiment, the term "associated with” means a covalent, non-peptide bond or a non- covalent bond. In some embodiments this association is indicated by a colon, i.e., (:).
  • covalent bond means a covalent bond except a peptide bond.
  • covalently associated means an association between two moieties by a covalent bond, e.g., a disulfide bond, a peptide bond, or one or more amino acids (e.g., a linker).
  • the amino acid cysteine comprises a thiol group that can form a disulfide bond or bridge with a thiol group on a second cysteine residue.
  • the CHI and CL regions are associated by a disulfide bond and the two heavy chains are associated by two disulfide bonds at positions corresponding to 239 and 242 using the Kabat numbering system (position 226 or 229, EU numbering system).
  • covalent bonds include, but are not limited to, a peptide bond, a metal bond, a hydrogen bond, a disulfide bond, a sigma bond, a pi bond, a delta bond, a glycosidic bond, an agnostic bond, a bent bond, a dipolar bond, a Pi backbond, a double bond, a triple bond, a quadruple bond, a quintuple bond, a sextuple bond, conjugation, hyperconjugation, aromaticity, hapticity, or antibonding.
  • Non- limiting examples of non-covalent bond include an ionic bond (e.g., cation-pi bond or salt bond), a metal bond, an hydrogen bond (e.g., dihydrogen bond, dihydrogen complex, low-barrier hydrogen bond, or symmetric hydrogen bond), van der Walls force, London dispersion force, a mechanical bond, a halogen bond, aurophilicity, intercalation, stacking, entropic force, or chemical polarity.
  • an ionic bond e.g., cation-pi bond or salt bond
  • a metal bond e.g., an hydrogen bond (e.g., dihydrogen bond, dihydrogen complex, low-barrier hydrogen bond, or symmetric hydrogen bond), van der Walls force, London dispersion force, a mechanical bond, a halogen bond, aurophilicity, intercalation, stacking, entropic force, or chemical polarity.
  • an ionic bond e.g., cation-pi bond
  • the term "monomer-dimer hybrid” used herein refers to a chimeric protein comprising a first polypeptide chain and a second polypeptide chain, which are associated with each other by a disulfide bond, wherein the first chain comprises a clotting factor, e.g., Factor VIII, and an Fc region and the second chain comprises, consists essentially of, or consists of an Fc region without the clotting factor.
  • the monomer-dimer hybrid construct thus is a hybrid comprising a monomer aspect having only one clotting factor and a dimer aspect having two Fc regions.
  • cleavage site refers to a site recognized by an enzyme. Certain enzymatic cleavage sites comprise an intracellular processing site.
  • a polypeptide has an enzymatic cleavage site cleaved by an enzyme that is activated during the clotting cascade, such that cleavage of such sites occurs at the site of clot formation. Exemplary such sites include e.g., those recognized by thrombin, Factor XIa or Factor Xa.
  • Exemplary FXIa cleavage sites include, e.g, TQSFNDFTR (SEQ ID NO: 47) and SVSQTSKLTR (SEQ ID NO: 48).
  • Exemplary thrombin cleavage sites include, e.g, DFLAEGGGVR (SEQ ID NO: 49), TTKIKPR (SEQ ID NO: 50), LVPRG (SEQ ID NO: 55) and ALRPR (amino acids 1 to 5 of SEQ ID NO: 51).
  • Other enzymatic cleavage sites are known in the art.
  • processing site refers to a type of enzymatic cleavage site in a polypeptide which is the target for enzymes that function after translation of the polypeptide. In one embodiment, such enzymes function during transport from the Golgi lumen to the trans-Golgi compartment. Intracellular processing enzymes cleave polypeptides prior to secretion of the protein from the cell. Examples of such processing sites include, e.g., those targeted by the PACE/furin (where PACE is an acronym for Paired basic Amino acid Cleaving Enzyme) family of endopeptidases.
  • PCSK1 also known as PCl/Pc3
  • PCSK2 also known as PC2
  • PCSK3 also known as furin or PACE
  • PCSK4 also known as PC4
  • PCSK5 also known as PC5 or PC6
  • PCSK6 also known as PACE4
  • PCSK7 also known as PC7/LPC, PC8, or SPC7.
  • PCSK1 also known as PCl/Pc3
  • PCSK2 also known as PC2
  • PCSK3 also known as furin or PACE
  • PCSK4 also known as PC4
  • PCSK5 also known as PC5 or PC6
  • PCSK7 also known as PC7/LPC, PC8, or SPC7.
  • PCSK7 also known as PC7/LPC, PC8, or SPC7
  • Furin refers to the enzymes corresponding to EC No. 3.4.21.75.
  • Furin is subiiiisin- like proproteiri convertase, which is also known as PACE (Paired basic Amino acid Cleaving Enzyme). Furin deletes sections of inactive precursor proteins to convert them into biologically active proteins. During its intracellular transport, pro-peptide is cleaved from mature VWF molecule by a Furin enzyme in the Golgi.
  • Hemostatic disorder means a genetically inherited or acquired condition characterized by a tendency to hemorrhage, either spontaneously or as a result of trauma, due to an impaired ability or inability to form a fibrin clot. Examples of such disorders include the hemophilias. The three main forms are hemophilia A (factor VIII deficiency), hemophilia B (factor IX deficiency or "Christmas disease”) and hemophilia C (factor XI deficiency, mild bleeding tendency).
  • factor VIII deficiency factor VIII deficiency
  • hemophilia B factor IX deficiency or "Christmas disease”
  • hemophilia C factor XI deficiency, mild bleeding tendency
  • hemostatic disorders include, e.g., Von Willebrand disease, Factor XI deficiency (PTA deficiency), Factor XII deficiency, deficiencies or structural abnormalities in fibrinogen, prothrombin, Factor V, Factor VII, Factor X or factor XIII, Bernard-Soulier syndrome, which is a defect or deficiency in GPlb.
  • GPlb the receptor for VWF, can be defective and lead to lack of primary clot formation (primary hemostasis) and increased bleeding tendency), and thrombasthenia of Glanzman and Naegeli (Glanzmann thrombasthenia).
  • primary hemostasis primary hemostasis
  • Naegeli Glanzman and Naegeli
  • the chimeric molecules of the invention can be used prophylactically.
  • prophylactic treatment refers to the administration of a molecule prior to a bleeding episode.
  • the subject in need of a general hemostatic agent is undergoing, or is about to undergo, surgery.
  • the chimeric protein of the invention can be administered prior to or after surgery as a prophylactic.
  • the chimeric protein of the invention can be administered during or after surgery to control an acute bleeding episode.
  • the surgery can include, but is not limited to, liver transplantation, liver resection, dental procedures, or stem cell transplantation.
  • the chimeric protein of the invention is also used for on-demand (also referred to as "episodic") treatment.
  • on-demand treatment or “episodic treatment” refers to the administration of a chimeric molecule in response to symptoms of a bleeding episode or before an activity that may cause bleeding.
  • the on-demand (episodic) treatment can be given to a subject when bleeding starts, such as after an injury, or when bleeding is expected, such as before surgery.
  • the on- demand treatment can be given prior to activities that increase the risk of bleeding, such as contact sports.
  • acute bleeding refers to a bleeding episode regardless of the underlying cause.
  • a subject may have trauma, uremia, a hereditary bleeding disorder (e.g., factor VII deficiency) a platelet disorder, or resistance owing to the development of antibodies to clotting factors.
  • Treat, treatment, treating, as used herein refers to, e.g., the reduction in severity of a disease or condition; the reduction in the duration of a disease course; the amelioration of one or more symptoms associated with a disease or condition; the provision of beneficial effects to a subject with a disease or condition, without necessarily curing the disease or condition, or the prophylaxis of one or more symptoms associated with a disease or condition.
  • the term "treating" or "treatment” means maintaining a FVIII trough level at least about 1 IU/dL, 2 IU/dL, 3 IU/dL, 4 IU/dL, 5 IU/dL, 6 IU/dL, 7 IU/dL, 8 IU/dL, 9 IU/dL, 10 IU/dL, 11 IU/dL, 12 IU/dL, 13 IU/dL, 14 IU/dL, 15 IU/dL, 16 IU/dL, 17 IU/dL, 18 IU/dL, 19 IU/dL, or 20 IU/dL in a subject by administering a chimeric protein or a VWF fragment of the invention.
  • treating or treatment means maintaining a FVIII trough level between about 1 and about 20 IU/dL, about 2 and about 20 IU/dL, about 3 and about 20 IU/dL, about 4 and about 20 IU/dL, about 5 and about 20 IU/dL, about 6 and about 20 IU/dL, about 7 and about 20 IU/dL, about 8 and about 20 IU/dL, about 9 and about 20 IU/dL, or about 10 and about 20 IU/dL.
  • Treatment or treating of a disease or condition can also include maintaining FVIII activity in a subject at a level comparable to at least about 1%, 2%, 3%, 4%, 5%, 6%, 7%, 8%, 9%, 10%, 11%, 12%, 13%, 14%, 15%, 16%, 17%, 18%, 19%, or 20% of the FVIII activity in a non-hemophiliac subject.
  • the minimum trough level required for treatment can be measured by one or more known methods and can be adjusted (increased or decreased) for each person.
  • the present invention is directed to extending the half- life of a Factor VIII protein by preventing or inhibiting a FVIII half-life limiting factor (e.g. endogenous VWF) in vivo from associating with the FVIII protein.
  • a FVIII half-life limiting factor e.g. endogenous VWF
  • Endogenous VWF associates with about 95%) to about 98%> of FVIII in non-covalent complexes.
  • the endogenous VWFs bound to a FVIII protein are known to protect FVIII in various ways.
  • full length VWF (as a multimer having about 250 kDa) can protect FVIII from protease cleavage and FVIII activation, stabilize the FVIII heavy chain and/or light chain, and prevent clearance of FVIII by scavenger receptors.
  • endogenous VWF limits the FVIII half-life by preventing pinocytosis and by clearing FVIII-VWF complex from the system through the VWF clearance pathway. It is believed, as shown in the examples, that endogenous VWF is the half-life limiting factor that prevents the half-life of a FVIII protein fused to a half-life extender from being longer than about two-fold of wild-type FVIII. Therefore, the present invention prevents or inhibits interaction between endogenous VWF and a FVIII protein using an adjunct moiety, thereby preventing the FVIII protein from being cleared through the VWF clearance pathway and/or inducing pinocytosis.
  • the adjunct moiety is capable of preventing or inhibiting binding of the FVIII protein with endogenous VWF and has at least one VWF-like FVIII protecting property.
  • the adjunct moiety reduces clearance of FVIII from the system by preventing or inhibiting interaction with endogenous VWF.
  • the adjunct moieties of the present invention bind to or are associated with (e.g., via non-covalent bonding) a FVIII protein and/or physically or chemically block the VWF binding site on the FVIII protein.
  • the FVIII protein associated with the adjunct moiety is thus cleared from the circulation more slowly by one or more VWF clearance receptors, as compared to wild type FVIII or FVIII not associated with an adjunct moiety.
  • adjunct moieties of the present invention include, e.g., polypeptides or chemical or physical modifications, additions, deletions, or variations of the FVIII protein.
  • the adjunct moiety useful in the present invention can comprise a polypeptide, a non-polypeptide moiety, or both.
  • Non-limiting examples of the polypeptide useful as an adjunct moiety include, e.g., a VWF fragment described herein, an immunoglobulin constant region or a portion thereof, transferrin or a fragment thereof, albumin or a fragment thereof, an albumin binding moiety, a HAP sequence, a PAS sequence, or any combinations thereof.
  • Non-limiting examples of the non-polypeptide moiety includes polyethylene glycol (PEG), polysialic acid, hydroxyethyl starch (HES), a derivative thereof, or any combination thereof.
  • PEG polyethylene glycol
  • HES hydroxyethyl starch
  • Other such moieties useful in present invention are known in the art.
  • the adjunct moiety is associated (or linked) with the FVIII protein by a covalent or a non-covalent bond.
  • the physical blockage or chemical association (e.g., non-covalent bonding) between the adjunct moiety and the FVIII protein may not be strong enough to provide a stable complex comprising the FVIII protein and the adjunct moiety in the presence of endogenous VWF.
  • a VWF fragment forming a non-covalent bond with a FVIII protein without any other connections may readily be dissociated in vivo from the FVIII protein in the presence of endogenous VWF, replacing the VWF fragment (e.g., recombinant VWF, i.e., rVWF) with endogenous VWF. Therefore, the FVIII protein non-covalently bound to endogenous VWF would undergo the VWF clearance pathway and be cleared from the system.
  • VWF fragment e.g., recombinant VWF, i.e., rVWF
  • the linkage between the FVIII protein and the adjunct moiety is a covalent bond, e.g., a peptide bond, one or more amino acids, or a disulfide bond.
  • the association (i.e., linkage) between the adjunct moiety and the FVIII protein is a peptide bond or a linker between the FVIII protein and the adjunct moiety ("FVIII/ AM linker").
  • FVIII/ AM linker Non-limiting examples of the linker is described elsewhere herein.
  • the adjunct moiety is a polypeptide comprising, consisting essentially of, or consisting of at least about 10, 100, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1100, 1200, 1300, 1400, 1500, 1600, 1700, 1800, 1900, 2000, 2500, 3000, or 4000 amino acids.
  • the adjunct moiety is a polypeptide comprising, consisting essentially of, or consisting of about 100 to about 200 amino acids, about 200 to about 300 amino acids, about 300 to about 400 amino acids, about 400 to about 500 amino acids, about 500 to about 600 amino acids, about 600 to about 700 amino acids, about 700 to about 800 amino acids, about 800 to about 900 amino acids, or about 900 to about 1000 amino acids.
  • the adjunct moiety covalently associated with the FVIII protein is a VWF fragment described elsewhere herein.
  • the adjunct moiety chemically (e.g., non-covalently) binds to or physically blocks one or more VWF binding sites on a FVIII protein.
  • the VWF binding site on a FVIII protein is located within the A3 domain or the C2 domain of the FVIII protein.
  • the VWF binding site on a FVIII protein is located within the A3 domain and C2 domain.
  • the VWF binding site on a FVIII protein can correspond to amino acids 1669 to 1689 and/or 2303 to 2332 of SEQ ID NO: 16 [full-length mature FVIII].
  • a chimeric protein of the invention comprises a FVIII protein linked to an adjunct moiety, wherein the adjunct moiety is a VWF molecule, e.g. a VWF fragment comprising a D' domain and a D3 domain, but not containing the VWF clearance receptor binding site, and shields or protects the VWF binding site on the FVIII protein, thereby inhibiting or preventing interaction of the FVIII protein with endogenous VWF.
  • the adjunct moiety is a VWF fragment.
  • the VWF fragment useful for the present invention contains the D' domain and the D3 domain, still providing one or more advantages of VWF-like property to the FVIII protein, but the VWF fragment does not undergo the VWF clearance pathway.
  • the FVIII protein and the adjunct moiety can be covalently associated by a linker (e.g., FVIII/ AM linker).
  • the linker can be a cleavable linker.
  • Non-limiting examples of the linkers are disclosed elsewhere herein.
  • a chimeric protein of the invention comprises a FVIII protein and an immunoglobulin constant region or a portion thereof (i.e., an adjunct moiety), wherein the immunoglobulin constant region or a portion thereof shields or protects the VWF binding site on the FVIII protein, thereby inhibiting or preventing interaction of the FVIII protein with endogenous VWF.
  • the immunoglobulin constant region or a portion thereof is an Fc region.
  • the present invention is directed to a chimeric or fusion protein or hybrid comprising one or more of the VWF fragments disclosed herein and uses of the same.
  • the chimeric or fusion protein can be fused or linked to one or more heterologous moiety (sometimes indicated herein as H or HI).
  • the heterologous moiety (HI) is a heterologous peptide or a heterologous polypeptide that would not naturally occur with and/or is linked to the VWF fragment.
  • the heterologous moiety (HI) is a non-polypeptide moiety, e.g., chemical modification or a combination of a peptide or polypeptide and a non-polypeptide moiety.
  • the VWF fragments are linked or connected to the heterologous moiety (HI) by a linker (also referred to herein as "VWF linker").
  • VWF linker also referred to herein as "VWF linker”
  • the VWF linker is a cleavable linker.
  • Non-limiting examples of the linker between the VWF fragment and the heterologous moiety (HI) are disclosed elsewhere herein.
  • the heterologous moiety (HI) useful in the invention improves one or more pharmacokinetic properties of the VWF fragments without significantly affecting the VWF fragments' biological activity or function (e.g., its binding to or association with a FVIII protein).
  • the heterologous moiety (HI) linked to the VWF fragment can extend the half-life of the VWF fragments.
  • Non-limiting examples of the heterologous polypeptide moiety comprises an immunoglobulin constant region or a portion thereof, albumin or a fragment thereof, an albumin binding moiety, a PAS sequence, a HAP sequence, transferrin or a fragment thereof, or two or more combinations thereof.
  • heterologous non-polypeptide moiety examples include polyethylene glycol (PEG), polysialic acid, hydroxyethyl starch (HES), a derivative thereof, or any combinations thereof.
  • PEG polyethylene glycol
  • HES hydroxyethyl starch
  • HI heterologous moiety
  • VWF fragment and the FVIII protein by a covalent bond.
  • heterologous moiety that can provide the covalently linkage include, but are not limited to, an immunoglobulin constant region or a portion thereof comprising a hinge region, e.g., an Fc region or an FcRn binding partner.
  • the FVIII protein is linked to a first Fc region
  • the VWF fragment is linked to a second Fc region, wherein the first Fc region and the second Fc region form one or more disulfide bond.
  • heterologous moiety (sometimes indicated herein by
  • H or "HI” is an immunoglobulin constant region or a portion thereof.
  • the immunoglobulin constant region or a portion thereof can be selected from the group consisting of a CHI domain, a CH2 domain, a CH3 domain, a CH4 domain, a hinge domain, and two or more combinations thereof.
  • the immunoglobulin constant region or a portion thereof comprises at least one CHI domain, at least one CH2 domain, at least one CH3 domain, at least one CH4 domain, or the functional fragments thereof.
  • the immunoglobulin constant region or a portion thereof comprises at least one hinge domain or a portion thereof and at least one CH2 domain or a portion thereof (e.g., in the hinge-CH2 orientation).
  • the immunoglobulin constant domain or a portion thereof comprises at least one CH2 domain or a portion thereof and at least one CH3 domain or a portion thereof (e.g., in the CH2-CH3 orientation.)
  • Examples of the combination include, but are not limited to, a CH2 domain, a CH3 domain, and a hinge domain, which are also known as an Fc region (or Fc domain), e.g., a first Fc region.
  • the heterologous moiety (HI) is linked to the VWF fragment by a linker.
  • the heterologous moiety (HI) is an FcRn binding partner as described elsewhere herein.
  • the heterologous moiety (HI) is a hinge region.
  • the chimeric protein further comprises a second (or additional) heterologous moiety (sometimes indicated herein by "H2").
  • a second heterologous moiety (sometimes indicated herein by "H2").
  • the second heterologous moiety (H2) can be linked to the FVIII protein or elsewhere in the chimeric protein by a peptide bond, one or more amino acids, or by a linker (e.g., FVIII linker if linked to FVIII).
  • a linker e.g., FVIII linker if linked to FVIII.
  • Such constructs can sometimes be referred to as FVIII/VWF heterodimer.
  • the heterologous moiety (H2) comprises a heterologous polypeptide.
  • the heterologous moiety (H2) comprises a non-polypeptide moiety.
  • the heterologous moiety (H2) comprises a combination of a heterologous moiety and a non-polypeptide moiety.
  • the second heterologous moiety (H2) can be a half-life extender.
  • Non-limiting examples of the second heterologous polypeptide moiety (H2) include an immunoglobulin constant region or a portion thereof, albumin or a fragment thereof, an albumin binding moiety, a PAS sequence, a HAP sequence, transferrin or a fragment thereof, or two or more combinations thereof.
  • heterologous non-polypeptide moiety examples include polyethylene glycol (PEG), polysialic acid, hydroxyethyl starch (HES), a derivative thereof, or any combinations thereof.
  • the first heterologous moiety (HI) and the second heterologous moiety are the same or different. Either or both of the first heterologous moiety (HI) and the second heterologous moiety (H2) can confer half-life extension to the FVIII protein in a chimeric protein, provide a connection stronger than non-covalent association, i.e., by one or more covalent bonds between the FVIII protein and the VWF fragment in a chimeric protein, or both.
  • the VWF fragment fused or linked to the first heterologous moiety removes the half-life ceiling by preventing or inhibiting interaction between the FVIII protein and the endogenous VWF protein
  • the FVIII protein fused to the heterologous moieties can reach to its full potential and can have a half-life of longer than two-fold compared to wild type FVIII.
  • the first heterologous moiety (e.g., a first Fc region) linked to the VWF fragment and the second heterologous moiety (e.g., a second Fc region) linked to the FVIII protein are associated with each other such that the association prevents replacement of the VWF fragment by endogenous VWF in vivo.
  • the second heterologous moiety is a second Fc region, wherein the second Fc region is linked to or associated with the first heterologous moiety, e.g., the first Fc region, by a covalent bond, e.g., disulfide bond, a peptide bond, or a linker (one or more amino acids).
  • the second heterologous moiety (e.g., the second Fc region) linked to the FVIII protein at one end can be further linked to the first heterologous moiety (e.g., the first Fc region) linked to the VWF fragment by a linker (e.g., scFc linker) or associated with the first heterologous moiety by a covalent or non-covalent bond.
  • the second heterologous moiety (e.g., the second Fc region) is linked to the VWF fragment that is already linked to first heterologous moiety.
  • the chimeric protein comprises a first polypeptide chain comprising a VWF fragment and a first heterologous moiety and a second polypeptide chain comprising a FVIII protein and a second heterologous moiety, wherein the first polypeptide chain and the second polypeptide chain are associated, wherein the association between the first polypeptide chain comprising the first heterologous moiety and the second polypeptide chain comprising the second heterologous moiety is a covalent bond, thus allowing the VWF fragment and the FVIII protein maintain its interaction with each other.
  • endogenous VWF which can form a non- covalent bond with the FVIII protein cannot replace the covalently linked polypeptide chain comprising the VWF fragment.
  • VWF linker can be a cleavable linker, e.g., a thrombin cleavable linker.
  • the cleavable linkers can be cleaved by a protease selected from the group consisting of factor XIa, factor Xlla, kallikrein, factor Vila, factor IXa, factor Xa, factor Ila (thrombin), Elastase-2, Granzyme-B, TEV, Enterokinase, Protease 3C, Sortase A, MMP-12, MMP- 13, MMP-17, MMP-20, and any combinations thereof.
  • These cleavable linkers allow the VWF fragment to be cleaved and dissociated from the FVIII protein upon activation of the clotting cascade, resulting in a FVIII protein with full activity potential.
  • the chimeric protein is produced as a single polypeptide chain comprising a VWF fragment, a cleavable linker, a first heterologous moiety (HI), a processable linker, a FVIII protein, and a second heterologous moiety (H2) in any order.
  • the processable linker can be cleaved by an intracellular protease enzyme before secretion, thus making two polypeptide chains as described above.
  • the second heterologous moiety e.g., the second Fc region
  • one or more linkers can comprise one or more cleavage sites.
  • the chimeric protein of the invention further comprises a third heterologous moiety (sometimes indicated herein by "H3").
  • the third heterologous moiety (H3) can be a half-life extender.
  • the heterologous moiety (H3) can comprise a heterologous polypeptide, a non-polypeptide moiety, or a combination of both.
  • Non- limiting examples of the third heterologous moiety (H3) include an immunoglobulin constant region or a portion thereof, albumin or a fragment thereof, an albumin binding moiety, a PAS sequence, a HAP sequence, transferrin or a fragment thereof, any derivatives or variants thereof, or two or more combinations thereof.
  • Non-limiting examples of the non-polypeptide moiety include polyethylene glycol (PEG), polysialic acid, hydroxyethyl starch (HES), a derivative thereof, or any combinations thereof.
  • the first heterologous moiety (HI) linked to the VWF fragment, the second heterologous moiety (H2) linked to the FVIII protein, and the third heterologous moiety (H3) can be the same or different.
  • the first heterologous moiety (HI) is identical to the second heterologous moiety (H2), but is different from the third heterologous moiety (H3).
  • the third heterologous moiety (H3) is fused or linked to a FVIII protein or a VWF fragment of the chimeric protein.
  • the third heterologous moiety is inserted within one or more domains of the FVIII protein or between two domains of the FVIII protein.
  • a chimeric protein comprises a first polypeptide chain and a second polypeptide chain, wherein the first chain comprises a FVIII protein linked to a first heterologous moiety (HI), e.g., a first Fc region, by an optional linker (e.g., FVIII linker) and the second chain comprises a VWF fragment linked to a second heterologous moiety (H2), e.g., a second Fc region, by an optional linker (e.g., VWF linker).
  • HI heterologous moiety
  • H2 second heterologous moiety
  • the FVIII protein can further comprise a third heterologous moiety (H3), e.g., any half-life extending moiety, e.g., albumin, or a PAS sequence, between FVIII heavy chain and FVIII light chain (i.e., amino acid residue 1648 of SEQ ID NO: 16), thus being a single chain FVIII protein.
  • H3 third heterologous moiety
  • FVIII heavy chain and FVIII light chain i.e., amino acid residue 1648 of SEQ ID NO: 16
  • the FVIII protein can be a dual chain protein, i.e., the FVIII heavy chain and the FVIII light chain associated with each other by a covalent or non-covalent bond (e.g., a metal bond), wherein the heavy chain is further linked to a third heterologous moiety (H3), e.g., a non-structural half-life extending polypeptide, albumin or a fragment thereof or a PAS sequence.
  • H3 heterologous moiety
  • a chimeric protein comprises a first polypeptide chain and a second polypeptide chain, wherein the first chain comprises a FVIII protein linked to a first heterologous moiety (HI), e.g., a first Fc region, by an optional linker (e.g, FVIII linker) and the second chain comprises a VWF fragment linked to a third heterologous moiety (H3), e.g., a non-structural half-life extending polypeptide, albumin or a PAS sequence, which is linked to a second heterologous moiety (H2), e.g., a second Fc region, by an optional linker.
  • H3 e.g., a non-structural half-life extending polypeptide, albumin or a PAS sequence
  • the third heterologous moiety (e.g., a half-life extending polypeptide) can be linked to the C-terminus or N-terminus of the FVIII protein or inserted between two domains of the FVIII protein or between two amino acids in a domain of the FVIII protein.
  • the chimeric protein of the invention further comprises a fourth heterologous moiety (sometimes indicated herein by "H4") and/or a fifth heterologous moiety (sometimes indicated herein by "H5").
  • the fourth or fifth heterologous moiety can also be a half-life extender.
  • the fourth heterologous moiety and/or the fifth heterologous moiety can be the same or different from the third heterologous moiety.
  • the heterologous moiety can comprise a heterologous polypeptide, a non-polypeptide moiety, or a combination of both.
  • Non- limiting examples of the fourth or fifth heterologous moiety include an immunoglobulin constant region or a portion thereof, albumin or a fragment thereof, an albumin binding moiety, a PAS sequence, a HAP sequence, transferrin or a fragment thereof, any derivatives or variants thereof, or two or more combinations thereof.
  • Non-limiting examples of the non-polypeptide moiety include polyethylene glycol (PEG), polysialic acid, hydroxyethyl starch (HES), a derivative thereof, or any combinations thereof.
  • the first heterologous moiety, the second heterologous moiety, the third heterologous moiety, the fourth heterologous moiety, and the fifth heterologous moiety can be the same or different.
  • the fourth heterologous moiety (e.g., a half-life extending polypeptide) can be linked to the C-terminus or N-terminus of the FVIII protein or inserted between two domains of the FVIII protein or between two amino acids in a domain of the FVIII protein.
  • the fifth heterologous moiety (e.g., a half-life extending polypeptide) can also be linked to the C-terminus or N-terminus of the FVIII protein or inserted between two domains of the FVIII protein or between two amino acids in a domain of the FVIII protein.
  • the chimeric protein comprises a FVIII protein, a VWF fragment, a first heterologous moiety, a second heterologous moiety, a third heterologous moiety, a fourth heterologous moiety, and a fifth heterologous moiety, wherein the first heterologous moiety and the second heterologous moiety forms a bond (e.g., a covalent bond) between the chain comprising the FVIII protein and the chain comprising the VWF fragment, and the third heterologous moiety, the fourth heterologous moiety, and the fifth heterologous moiety are half-life extenders, and wherein the bond between the chain comprising the FVIII protein and the chain comprising the VWF fragment is stronger than the non-covalent interaction between the FVIII and the VWF fragment, thereby preventing binding of endogenous VWF to the FVIII protein in vivo, in vitro, or ex vivo.
  • a bond e.g., a covalent bond
  • the chimeric protein comprises a FVIII protein, a VWF fragment, a first heterologous moiety, a second heterologous moiety, a third heterologous moiety, a fourth heterologous moiety, a fifth heterologous moiety, and a sixth heterologous moiety (sometimes indicated herein as "H6"), wherein the first heterologous moiety and the second heterologous moiety forms a bond between the chain comprising the FVIII protein and the chain comprising the VWF fragment, and the third heterologous moiety, the fourth heterologous moiety, the fifth heterologous moiety, and the sixth heterologous moiety are half-life extenders, and wherein the bond between the chain comprising the FVIII protein and the chain comprising the VWF fragment is stronger than the interaction between the FVIII and the VWF fragment, thereby preventing binding of endogenous VWF to the FVIII protein in vivo, in vitro, or ex vivo.
  • H6 heterologous moiety
  • a chimeric protein comprises a formula selected from the group consisting of:
  • V comprises a VWF fragment described herein;
  • Each of LI and L2 comprises an optional linker
  • HI comprises a first heterologous moiety
  • H2 comprises an optional second heterologous moiety. Either or both of the first heterologous moiety and the second heterologous moiety can be a half-life extending moiety.
  • HI comprises a polypeptide, a non-polypeptide moiety, or both.
  • the polypeptide useful as HI can comprise an immunoglobulin constant region or a portion thereof, albumin or a fragment thereof, an albumin binding moiety, a PAS sequence, a HAP sequence, any derivatives or variants, or any combinations thereof.
  • the non-polypeptide moiety can comprise polyethylene glycol (PEG), polysialic acid, and hydroxyethyl starch (HES), a derivative or variant thereof, or any combinations thereof.
  • H2 comprises a polypeptide, a non-polypeptide moiety, or both.
  • the polypeptide useful as H2 can comprise an immunoglobulin constant region or a portion thereof, albumin or a fragment thereof, an albumin binding moiety, a PAS sequence, a HAP sequence, any derivatives or variants, or any combinations thereof.
  • the non-polypeptide moiety can comprise polyethylene glycol (PEG), polysialic acid, hydroxyethyl starch (HES), a derivative or variant thereof, or any combinations thereof.
  • the linker between HI and H2 in formulas (aa) and (bb) is a processable linker.
  • the linker between the VWF fragment and HI in formulas (aa) and (bb) is a cleavable linker, e.g., a thrombin cleavable linker that can be cleaved by thrombin.
  • formula H-L-V means formula NH2-H-L-V-COOH.
  • the formulas described herein can comprise additional sequences between the two moieties.
  • formula V-L1-H1-L2-H2 can further comprise sequences at the N-terminus of V, between V and LI, between LI and HI, between HI or L2, between L2 or H2, or at the C-terminus of H2 unless otherwise specified.
  • the hyphen (-) indicates a peptide bond or one or more amino acids.
  • a chimeric protein comprises, consists essentially of, or consists of one or more formulas selected from the group consisting of (al) V-H, (a2) H- V, (a3) V-L-H, (a4) H-L-V, (a5) V-L1-H1-H2, (a6) H2-H1-L1-V, (a7) V-L1-H1 :H2, (a8) H2:H1-L1-V, (a9) V-H1 :H2, (bl) H2:H1-V, (b2) V-L1-H1-L2-H2, (b3) H2-L2-H1-L1-V, (b4) H1-V-H2, (b5) H1-L1-V-L2-H2, and (b6) H2-L2-V-L1-H1, wherein V comprises one or more of the VWF fragments described herein, L, LI, or L2 comprises a linker, H or HI comprises a
  • the first heterologous moiety (HI) can be a polypeptide, a non-polypeptide moiety, or both.
  • the heterologous polypeptide moiety can comprises an immunoglobulin constant region or a portion thereof, albumin or a fragment thereof, an albumin binding moiety, a PAS sequence, a HAP sequence, or any combinations thereof.
  • Non-limiting examples of the non- polypeptide moiety useful as HI include polyethylene glycol (PEG), polysialic acid, hydroxyethyl starch (HES), a derivative thereof, or any combinations thereof.
  • H2 comprises a second heterologous moiety.
  • the second heterologous moiety can be a polypeptide, a non-polypeptide moiety, or both.
  • the heterologous polypeptide moiety can comprises an immunoglobulin constant region or a portion thereof, albumin or a fragment thereof, an albumin binding moiety, a PAS sequence, a HAP sequence, or any combinations thereof.
  • Non-limiting examples of the non- polypeptide moiety useful as HI include polyethylene glycol (PEG), polysialic acid, hydroxyethyl starch (HES), a derivative thereof, or any combinations thereof.
  • the linker between the first heterologous moiety and the second heterologous moiety is a processable linker.
  • the linker between the VWF fragment and the first heterologous moiety or the second heterologous moiety is a cleavable linker, which comprises one or more cleavage sites, e.g., a thrombin cleavable linker.
  • the chimeric protein of the present invention comprises a formula selected from the group consisting of (aa), (bb), (cc), (dd), (al), (a2), (a3), (a4), (a5), (a6), (a7), (a8), (a9), (bl), (b2), (b3), (b4), (b5), and (b6) and a FVIII protein, which is covalently linked to or covalently associated with the VWF fragment, the first heterologous moiety (e.g., a first Fc region), or the second heterologous moiety (e.g., a second Fc region) of the formula.
  • a formula selected from the group consisting of (aa), (bb), (cc), (dd), (al), (a2), (a3), (a4), (a5), (a6), (a7), (a8), (a9), (bl), (b2), (b3), (b4), (b5), and (b6) and
  • the FVIII protein is linked to or associated with the VWF fragment by a covalent or non-covalent bond or by a linker.
  • the FVIII protein can be linked to the first heterologous moiety or the second heterologous moiety by a covalent or non-covalent bond or by a linker.
  • a chimeric protein of the present invention comprises a VWF fragment described herein covalently linked to or covalently associated with a FVIII protein.
  • the chimeric protein can comprise a VWF fragment and a FVIII protein, wherein the VWF fragment and the FVIII protein are bound by a covalent non- peptide bond, a peptide bond, a non-covalent bond, or by a linker, e.g., a cleavable linker.
  • the VWF fragment and the FVIII protein are bound to or interact with each other by one or more disulfide bonds.
  • the VWF fragment is bound to or interacts with the FVIII protein at the A3 domain of FVIII, the C2 domain of FVIII, or both the A3 domain and the C2 domain of FVIII by a non-covalent bond.
  • the VWF fragment bound to or interacting with the FVIII protein is linked or fused to a first heterologous moiety.
  • the FVIII protein bound to or interacting with the VWF fragment is further linked to a second heterologous moiety.
  • the VWF fragment bound to or interacting with the FVIII protein is further linked to a first heterologous moiety and the FVIII protein is further linked to a second heterologous moiety.
  • the first polypeptide chain comprising the VWF fragment and the first heterologous moiety and the second polypeptide chain comprising the FVIII protein and the second heterologous moiety are associated with each other such that the association does not allow interaction of the FVIII protein with other moieties, e.g., endogenous VWF.
  • the association is a covalent bond, e.g., a disulfide bond.
  • Each of the VWF fragment or the FVIII protein can be joined or connected to the first and second heterologous moiety by a linker, e.g., a cleavable linker, e.g., a thrombin cleavable linker.
  • a linker e.g., a cleavable linker, e.g., a thrombin cleavable linker.
  • the linker between the VWF fragment and the first heterologous moiety can be denoted herein as a VWF linker.
  • the linker between the FVIII protein and the second heterologous moiety can be denoted herein as a FVIII linker.
  • both of the VWF fragment or the FVIII protein can be joined or connected to the first and second heterologous moiety by a linker, e.g., a cleavable linker, e.g., a thrombin cleavable linker.
  • the first heterologous moiety linked to the VWF fragment comprises a polypeptide, a non-polypeptide moiety, or both.
  • Non-limiting examples of the first heterologous polypeptide moiety includes an immunoglobulin constant region or a portion thereof, albumin or a fragment thereof, an albumin binding moiety, a PAS sequence, a HAP sequence, transferrin or a fragment thereof, or two or more combinations thereof.
  • Non-limiting examples of the non-polypeptide moiety includes polyethylene glycol (PEG), polysialic acid, hydroxyethyl starch (HES or HAES), a derivative or variant thereof, or any combinations thereof.
  • the second heterologous moiety linked to the FVIII protein comprises a polypeptide, a non- polypeptide moiety, or both.
  • Non-limiting examples of the second heterologous moiety includes an immunoglobulin constant region or a portion thereof, albumin or a fragment thereof, an albumin binding moiety, a PAS sequence, a HAP sequence, transferrin or a fragment thereof, or two or more combinations thereof.
  • Non-limiting examples of the non-polypeptide moiety includes polyethylene glycol (PEG), polysialic acid, hydroxyethyl starch (HES or HAES), a derivative or variant thereof, or any combinations thereof.
  • the VWF fragment is attached to FVIII using sortase mediated in vitro protein ligation.
  • a sortase recognition motif is used.
  • the first heterologous moiety is an immunoglobulin constant region or a portion thereof.
  • the first heterologous moiety is a first Fc region.
  • the second heterologous moiety is an immunoglobulin constant region or a portion thereof.
  • the second heterologous moiety is a second Fc region.
  • the chimeric protein comprises a VWF fragment described herein and a FVIII protein, wherein the VWF fragment is linked to an immunoglobulin constant region or a portion thereof, which is an Fc region.
  • the chimeric protein comprises a VWF fragment described herein and a FVIII protein, wherein the FVIII protein is linked to an immunoglobulin constant region or a portion thereof, which is an Fc region.
  • a chimeric protein comprises a VWF fragment described herein and a FVIII protein, wherein the VWF fragment is linked to a first immunoglobulin constant region, which is a first Fc region, and the FVIII protein is linked to a second immunoglobulin constant region, which is a second Fc region, and wherein the VWF fragment and the FVIII protein is bound to or interact with each other by a non-covalent bond or the first Fc region or the second Fc region are associated with each other by a covalent bond.
  • the VWF fragment linked to the first heterologous moiety is further linked to the second heterologous moiety, e.g., a second Fc region, by a linker, e.g., a processable linker.
  • the VWF fragment is linked to the first heterologous moiety by a linker, e.g., VWF linker, e.g., a cleavable linker.
  • the FVIII protein is linked to the second heterologous moiety by a linker, e.g., FVIII linker, e.g., a cleavable linker.
  • heterologous moieties are disclosed elsewhere herein, e.g., immunoglobulin constant region or a portion thereof at paragraphs [0165] - [0193], albumin, fragment or variant thereof at paragraphs [0194]-[0198], HAP sequences at paragraph [0293], transferrin, fragments, or variants thereof at paragraphs [0204]-[0205], polymer, e.g., polyethylene glycol, at paragraphs [0206] - [0213], HES at paragraphs [0214] -[0219], or PSA at paragraph [0220]- and PAS sequences at paragraphs [0199]-[0202].
  • a chimeric protein of the present invention comprises , consists essentially of, or consists of a formula selected from the group consisting of:
  • V is a VWF fragment described herein;
  • each of LI or L2 is an optional linker, e.g., a cleavable linker, e.g., a thrombin cleavable linker;
  • L3 is an optional linker, e.g., a processable linker
  • each of HI and H2 is an optional heterologous moiety
  • C is a FVIII protein
  • (-) is a peptide bond or one or more amino acids.
  • a chimeric protein of the invention comprises a formula selected from the group consisting of:
  • V is a VWF fragment described herein;
  • each of LI or L2 is an optional linker, e.g., a thrombin cleavable linker;
  • each of HI or H2 is an optional heterologous moiety
  • (-) is a peptide bond or one or more amino acids; and C is a FVIII protein; and (:) is a chemical or physical association between HI and H2.
  • one or more of the heterologous moieties are a half-life extender.
  • Half-life extenders are known in the art, and non-limiting examples of such half-life extenders include an immunoglobulin constant region or a portion thereof, albumin or fragment thereof, an albumin binding moiety, a PAS sequence, a HAP sequence, transferrin or a fragment thereof, a derivative or variant thereof, or two or more combinations thereof.
  • the non-polypeptide moiety can comprise polyethylene glycol (PEG), polysialic acid, hydroxyethyl starch (HES), a derivative thereof, or any combinations thereof.
  • (:) in formulas (m) to (u) represents a chemical association, e.g., at least one non-peptide bond.
  • the chemical association, i.e., (:) is a covalent bond.
  • the chemical association, i.e., (:) is a non-covalent interaction, e.g., an ionic interaction, a hydrophobic interaction, a hydrophilic interaction, a Van der Waals interaction, a hydrogen bond.
  • (:) is a non-peptide covalent bond.
  • (:) is a peptide bond.
  • (:) in formulas (m) to (u) represents a physical association between two sequences, wherein a portion of a first sequence is in close proximity to a second sequence such that the first sequence shields or blocks a portion of the second sequence from interacting with another moiety, and further that this physical association is maintained without allowing the second sequence to interact with other moieties.
  • Formulas (a) - (u) are included herein merely as non-limiting examples of constructs of the present invention.
  • the orientation of the polypeptide formulas is shown from N-terminus (left) to C-terminus (right).
  • formula V-L1-H1-L3-C-L2- H2 means formula NH2-V-L1-H1-L3-C-L2-H2-COOH.
  • (:) can be an association or interaction between two polypeptide chains by a covalent bond or a non- covalent bond between any part of the first chain and any part of the second chain unless otherwise noted.
  • formula V-H1 :H2-C has two polypeptide chains, the first chain being V-Hl and the second chain being C-H2, wherein V in the first chain interacts or associates with C in the second chain and/or HI in the first chain interacts or associates with H2 in the second chain.
  • (:) means a covalent, non-peptide bond or non-covalent bond.
  • a chimeric protein comprises, consists essentially of, consists of a formula selected from the group consisting of:
  • V:C (2) H-V:C or C:V-H
  • V:C-H or H-C:V (3) V:C-H or H-C:V, (4) V-Hl :H2-C or H1-V:C-H2,
  • V is a VWF fragment described herein;
  • C is a FVIII protein
  • H or HI is a heterologous moiety or a first heterologous moiety
  • H2 is a second heterologous moiety; the first and second heterologous moieties can be the different;
  • Each of L, LI or L2 is an optional linker; (-) is a peptide bond or one or more amino acids; and
  • the linkers can each be the same or different and each can be a cleavable linker, comprising one or more enzymatic cleavage site.
  • the heterologous moieties can be a half-life extension technology that is known in the art, a polypeptide, a non-polypeptide moiety, or both.
  • a polypeptide moiety can comprise an immunoglobulin constant region or a portion thereof, albumin or a fragment thereof, an albumin binding moiety, a PAS sequence, a HAP sequence, any derivatives or variants thereof, or any combinations thereof (e.g., an Fc region).
  • a non-polypeptide moiety can comprise polyethylene glycol (PEG), polysialic acid, hydroxyethyl starch (HES), a derivative or variant thereof, or any combinations thereof.
  • PEG polyethylene glycol
  • HES hydroxyethyl starch
  • Each of the H, HI, or H2 can be individually selected based on the characteristics and can be all the same, or each one different.
  • heterologous moieties are disclosed elsewhere herein, e.g., immunoglobulin constant region or a portion thereof at paragraphs [0126] - [0153], albumin or fragment or variant thereof at paragraphs [0154]-[0157], polymer, e.g., polyethylene glycol, at paragraphs [0166] - [0173], and PAS sequences at paragraphs [0159]-[0162].
  • Formulas (1) - (68) are included herein merely as non- limiting examples of constructs of the present invention.
  • (:) represents a chemical association, e.g., at least one non- peptide bond.
  • the chemical association i.e., (:) is a covalent bond.
  • the chemical association i.e., (:) is a non-covalent interaction, e.g., an ionic interaction, a hydrophobic interaction, a hydrophilic interaction, a Van der Waals interaction, a hydrogen bond.
  • (:) is a non-peptide covalent bond.
  • (:) is a peptide bond.
  • (:) represents a physical association between two sequences, wherein a portion of a first sequence is in close proximity to a second sequence such that the first sequence shields or blocks a portion of the second sequence from interacting with another moiety, and further that this physical association is maintained without allowing the second sequence to interact with other moieties.
  • the first heterologous moiety (H or HI) linked to the VWF fragment in the chimeric protein is a first Fc region.
  • the second heterologous moiety (or H2) linked to the FVIII protein in the chimeric protein is a second Fc region.
  • a chimeric protein of the invention comprises two polypeptide chains, a first chain comprising, consisting essentially of, or consisting of an amino acid sequence encoding FVIII (e.g., single chain FVIII) and a first heterologous moiety (e.g., a first Fc region) and a second chain comprising, consisting essentially of, or consisting of an amino acid sequence encoding a VWF fragment comprising D' domain and D3 domain, a second heterologous moiety (e.g., a second Fc region), and a linker between the VWF fragment and the second Fc domain (e.g., VWF linker).
  • FVIII e.g., single chain FVIII
  • first heterologous moiety e.g., a first Fc region
  • a second chain comprising, consisting essentially of, or consisting of an amino acid sequence encoding a VWF fragment comprising D' domain and D3 domain, a second heterologous moiety (e.g
  • the linker between the VWF fragment and the second Fc domain can be a thrombin cleavable linker.
  • the single chain FVIII protein comprises a third heterologous moiety, e.g., a half-life extender, which is linked to the N-terminus, C- terminus, or one or more sites within the FVIII sequence.
  • a chimeric protein of the invention comprises three polypeptide chains, wherein a first chain comprises, consists essentially of, or consists of a heavy chain of FVIII, a second chain comprises, consists essentially of, or consists of a light chain of FVIII fused to a first heterologous moiety (e.g., a first Fc region), and a third polypeptide chain comprises, consists essentially of, or consists of a VWF fragment comprising the D' domain and the D3 domain, a second heterologous moiety (e.g, a second Fc region), and a linker.
  • a first chain comprises, consists essentially of, or consists of a heavy chain of FVIII
  • a second chain comprises, consists essentially of, or consists of a light chain of FVIII fused to a first heterologous moiety (e.g., a first Fc region)
  • a third polypeptide chain comprises, consists essentially of, or consists of a VW
  • the linker between the VWF fragment and the second heterologous moiety can be a thrombin cleavable linker.
  • the heavy chain FVIII is linked to a third heterologous moiety, e.g., a half-life extender, which can be linked to the N-terminus, C-terminus, or one or more sites within the FVIII sequence.
  • a chimeric protein of the invention comprises two polypeptide chains, a first chain comprising, consisting essentially of, or consisting of a heavy chain of FVIII and a second chain comprising, consisting essentially of, or consisting of a light chain of FVIII, a first heterologous moiety (e.g., a first Fc region), a first linker (e.g., a protease cleavage site comprising one or more intracellular processing sites), a VWF fragment, a second linker (e.g., a thrombin cleavable linker), and a second heterologous moiety (e.g., a second Fc region), wherein the light chain of FVIII is linked to the first heterologous moiety (e.g., the first Fc region), which is further linked to the VWF fragment by the first linker (e.g.
  • the first linker and the second linker are identical or different.
  • a chimeric protein of the invention comprises one polypeptide chain, which comprises a single chain FVIII protein, a first heterologous moiety (e.g., a first Fc region), a first linker (e.g., a thrombin cleavable linker), a VWF fragment, a second linker (e.g., a thrombin cleavable linker), and a second heterologous moiety (e.g., a second Fc region), wherein the single chain FVIII protein is linked to the first heterologous moiety, which is also linked to the VWF fragment by the first linker, and the VWF fragment is linked to the second Fc region by the second linker.
  • a first heterologous moiety e.g., a first Fc region
  • a first linker e.g., a thrombin cleavable linker
  • VWF fragment e.g., a thrombin cleavable linker
  • the first linker is a cleavable linker comprising a first cleavable site and a second cleavable site.
  • the second linker is a cleavable linker comprising one or two cleavable sites.
  • the second linker is a thrombin cleavable linker.
  • the linker useful in the invention can be any length, e.g., at least 10, 50, 100, 200, 300, 400, 500, 600, or 700 amino acids.
  • the linker can be 20 amino acids, 35 amino acids, 42 amino acids, 73 amino acids, or 98 amino acids.
  • the VWF fragment is directly linked to the FVIII protein by a peptide bond or a linker.
  • an enzymatic ligation e.g., sortase
  • sortase refers to a group of prokaryotic enzymes that modify surface proteins by recognizing and cleaving a carboxyl-terminal sorting signal.
  • the recognition signal consists of the motif LPXTG (Leu- Pro-any-Thr-Gly (SEQ ID NO: 106), then a highly hydrophobic transmembrane sequence, then a cluster of basic residues such as arginine. Cleavage occurs between the Thr and Gly, with transient attachment through the Thr residue to the active site Cys residue of a ligation partner, followed by transpeptidation that attaches the protein covalently to the cell wall.
  • the ligation partner contains Gly(n).
  • a VWF fragment linked to a sortase recognition motif by an optional linker can be fused to a FVIII protein linked to Gly(n) by a sortase, wherein n can be any integer.
  • a ligation construct comprises the VWF fragment (N-terminal portion of the construct) and the FVIII protein (C-terminal portion of the construct), wherein the sortase recognition motif is inserted in between.
  • An exemplary construct is shown in Figure 24(A).
  • Another ligation construct comprises the VWF fragment (N- terminal portion of the construct, the linker, the sortase recognition motif, and the FVIII protein (C-terminal portion of the construct) (e.g., Figure 24(C)).
  • a FVIII protein linked to a sortase recognition motif by an optional linker can be fused to a VWF fragment linked to Gly(n) by a sortase, wherein n is any integer.
  • a resulting ligation construct comprises the FVIII protein (N-terminal portion of the construct) and the VWF fragment (C-terminal portion of the construct), wherein the sortase recognition motif is inserted in between.
  • An exemplary construct is shown in Figure 24(B).
  • Another resulting ligation construct comprises the FVIII protein (N-terminal portion of the construct), the linker, the sortase recognition motif, and the VWF fragment (C-terminal portion of the construct) (e.g., Figure 24(D)).
  • a VWF fragment linked to a sortase recognition motif by a first optional linker can be fused to a heterologous moiety, e.g., an immunoglobulin constant region or a portion thereof, e.g., an Fc region, linked to a thrombin cleavage site by a second optional linker.
  • a resulting construct can comprise the VWF fragment (N-terminal portion), the first linker, the sortase recognition motif, the protease cleavage site, the second optional linker, and the heterologous moiety (e.g., Figure 24(E)).
  • this resulting construct is a part of a chimeric protein comprising the FVIII protein and a second heterologous moiety, e.g., an immunoglobulin constant region or a portion thereof, e.g., a second Fc region.
  • a chimeric comprises three polypeptide chains, the first chain comprising a VWF fragment, the first linker, the sortase recognition motif, the protease cleavage site, the second optional linker, the first heterologous moiety, the second chain comprising the light chain of the FVIII protein and the second heterologous moiety, and the third chain comprising the heavy chain of the FVIII protein.
  • the chimeric protein of the invention comprising a
  • VWF fragment and a FVIII protein wherein the VWF fragment and the FVIII protein are covalently associated with each other or covalently linked to each other has less immunogenicity than a FVIII protein without the VWF fragment.
  • the reduced immunogenicity includes, but is not limited to, less humoral immune response, e.g., less neutralizing antibody titer, or less cell-mediated immune response against FVIII, e.g., production of various cytokines.
  • the half-life of the FVIII protein (or a chimeric protein) is extended compared to a FVIII protein without the VWF fragment or wildtype FVIII.
  • the half-life of the FVIII protein is at least about 1.5 times, at least about 2 times, at least about 2.5 times, at least about 3 times, at least about 4 times, at least about 5 times, at least about 6 times, at least about 7 times, at least about 8 times, at least about 9 times, at least about 10 times, at least about 11 times, or at least about 12 times longer than the half-life of a FVIII protein without the VWF fragment.
  • the half-life of FVIII is about 1.5-fold to about 20-fold, about 1.5 fold to about 15 fold, or about 1.5 fold to about 10 fold longer than the half-life of wild-type FVIII.
  • the half- life of the FVIII is extended about 2-fold to about 10-fold, about 2-fold to about 9-fold, about 2-fold to about 8-fold, about 2-fold to about 7-fold, about 2-fold to about 6-fold, about 2-fold to about 5-fold, about 2-fold to about 4- fold, about 2-fold to about 3-fold, about 2.5-fold to about 10-fold, about 2.5-fold to about 9-fold, about 2.5-fold to about 8-fold, about 2.5-fold to about 7-fold, about 2.5-fold to about 6-fold, about 2.5 -fold to about 5 -fold, about 2.5 -fold to about 4-fold, about 2.5 -fold to about 3-fold, about 3-fold to about 10-fold, about 3-fold to about 9-fold, about 3-fold to about 8-fold, about 3-fold to about 7-fold, about 3-fold to about 6-fold, about 3-fold to about 5 -fold, about 3 -fold to about 4-fold, about 4-fold to about 6 fold, about 5 -fold to about 7-fold, or about 6-fold to about 8 fold as compared
  • the half-life of FVIII is at least about 17 hours, at least about 18 hours, at least about 19 hours, at least about 20 hours, at least about 21 hours, at least about 22 hours, at least about 23 hours, at least about 24 hours, at least about 25 hours, at least about 26 hours, at least about 27 hours, at least about 28 hours, at least about 29 hours, at least about 30 hours, at least about 31 hours, at least about 32 hours, at least about 33 hours, at least about 34 hours, at least about 35 hours, at least about 36 hours, at least about 48 hours, at least about 60 hours, at least about 72 hours, at least about 84 hours, at least about 96 hours, or at least about 108 hours.
  • the half- life of FVIII is about 15 hours to about two weeks, about 16 hours to about one week, about 17 hours to about one week, about 18 hours to about one week, about 19 hours to about one week, about 20 hours to about one week, about 21 hours to about one week, about 22 hours to about one week, about 23 hours to about one week, about 24 hours to about one week, about 36 hours to about one week, about 48 hours to about one week, about 60 hours to about one week, about 24 hours to about six days, about 24 hours to about five days, about 24 hours to about four days, about 24 hours to about three days, or about 24 hours to about two days.
  • the average half-life of the FVIII protein per subject is about 15 hours, about 16 hours, about 17 hours, about 18 hours, about 19 hours, about 20 hours, about 21 hours, about 22 hours, about 23 hours, about 24 hours (1 day), about 25 hours, about 26 hours, about 27 hours, about 28 hours, about 29 hours, about 30 hours, about 31 hours, about 32 hours, about 33 hours, about 34 hours, about 35 hours, about 36 hours, about 40 hours, about 44 hours, about 48 hours (2 days), about 54 hours, about 60 hours, about 72 hours (3 days), about 84 hours, about 96 hours (4 days), about 108 hours, about 120 hours (5 days), about six days, about seven days (one week), about eight days, about nine days, about 10 days, about 11 days, about 12 days, about 13 days, or about 14 days.
  • VWF fragment is extendable in FVIII/VWF double knockout ("DKO") mice compared to a polypeptide consisting of FVIII or a FVIII monomer-dimer hybrid.
  • VWF Von Willebrand Factor
  • VWF also known as F8VWF
  • F8VWF is a large multimeric glycoprotein present in blood plasma and produced constitutively in endothelium (in the Weibel-Palade bodies), megakaryocytes (a-granules of platelets), and subendothelian connective tissue.
  • the basic VWF monomer is a 2813 amino acid protein.
  • Every monomer contains a number of specific domains with a specific function, the D' and D3 domains (which together bind to Factor VIII), the Al domain (which binds to platelet GPIb-receptor, heparin, and/or possibly collagen), the A3 domain (which binds to collagen), the CI domain (in which the RGD domain binds to platelet integrin ⁇ ) ⁇ 3 when this is activated), and the "cysteine knot" domain at the C-terminal end of the protein (which VWF shares with platelet- derived growth factor (PDGF), transforming growth factor- ⁇ (TGFP) and ⁇ -human chorionic gonadotropin (PHCG)).
  • PDGF platelet- derived growth factor
  • TGFP transforming growth factor- ⁇
  • PHCG ⁇ -human chorionic gonadotropin
  • SEQ ID NO: 1 is the amino acid sequence encoded by SEQ ID NO: 1. Each domain of VWF is listed in Table 1.
  • VWF D1D2 region 23 AEGTRGRS STARCSLFGS
  • ATATCCGTCA CACACAGGGG AACGCGGTCC TGGACGGTCT CGGACGTGTA
  • CTGTCGAGGA CCTACTTCCG
  • GAGACGCACC TCTCGTGGCT CACAGGGACG
  • the VWF fragment binds to or is associated with a FVIII protein.
  • a VWF fragment of the invention protects FVIII from protease cleavage and FVIII activation, stabilizes the heavy chain and light chain of FVIII, and prevents clearance of FVIII by scavenger receptors.
  • the VWF fragment binds to or associates with a FVIII protein and blocks or prevents binding of the FVIII protein to phospholipid and activated Protein C.
  • the VWF fragment of the invention reduces the clearance of FVIII by VWF clearance receptors and thus extends the half-life of FVIII.
  • the half-life extension of a FVIII protein is thus due to the binding of or associating with the VWF fragment lacking a VWF clearance receptor binding site to the FVIII protein and shielding or protecting of the FVIII protein by the VWF fragment from endogenous VWF which contains the VWF clearance receptor binding site.
  • the FVIII protein bound to or protected by the VWF fragment can also allow recycling of a FVIII protein. Therefore, the VWF fragment cannot be full- length mature VWF.
  • the VWF fragment comprising the D' domain and the D3 domain can further comprise a VWF domain selected from the group consisting of an A 1 domain, an A2 domain, an A3 domain, a Dl domain, a D2 domain, a D4 domain, a Bl domain, a B2 domain, a B3 domain, a CI domain, a C2 domain, a CK domain, one or more fragments thereof, and any combinations thereof.
  • a VWF fragment comprises, consists essentially of, or consists of: (1) the D' and D3 domains of VWF or fragments thereof; (2) the Dl, D', and D3 domains of VWF or fragments thereof; (3) the D2, D', and D3 domains of VWF or fragments thereof; (4) the Dl, D2, D', and D3 domains of VWF or fragments thereof; or (5) the Dl, D2, D', D3, and Al domains of VWF or fragments thereof.
  • the VWF fragment described herein does not contain a site binding to a VWF clearance receptor.
  • the VWF fragment described herein is not amino acids 764 to 1274 of SEQ ID NO: 2.
  • the VWF fragment of the present invention can comprise any other sequences linked to or fused to the VWF fragment, but is not the full-length VWF.
  • a VWF fragment described herein can further comprise a signal peptide.
  • a VWF fragment of the present invention comprises the D' domain and the D3 domain of VWF, wherein the D' domain is at least 60%, 70%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99%, or 100% identical to amino acids 764 to 866 of SEQ ID NO: 2, wherein the VWF fragment binds to a FVIII protein, shields, inhibits or prevents binding of endogenous VWF fragment to a FVIII protein.
  • a VWF fragment comprises the D' domain and the D3 domain of VWF, wherein the D3 domain is at least 60%, 70%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99%, or 100% identical to amino acids 867 to 1240 of SEQ ID NO: 2, wherein the VWF fragment binds to a FVIII protein or inhibits or prevents binding of endogenous VWF fragment to a FVIII protein.
  • a VWF fragment described herein comprises, consists essentially of, or consists of the D' domain and D3 domain of VWF, which are at least 60%, 70%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99%, or 100% identical to amino acids 764 to 1240 of SEQ ID NO: 2, wherein the VWF fragment binds to a FVIII protein or inhibits or prevents binding of endogenous VWF fragment to a FVIII protein.
  • a VWF fragment comprises, consists essentially of, or consists of the Dl, D2, D', and D3 domains at least 60%, 70%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99%, or 100% identical to amino acids 23 to 1240 of SEQ ID NO: 2, wherein the VWF fragment binds to a FVIII protein or inhibits or prevents binding of endogenous VWF fragment to a FVIII protein.
  • the VWF fragment further comprises a signal peptide operably linked thereto.
  • a VWF fragment of the invention consists essentially of or consists of (1) the D'D3 domain, the D1D'D3 domain, D2D'D3 domain, or D1D2DO3 domain and (2) an additional VWF sequence up to about 10 amino acids (e.g., any sequences from amino acids 764 to 1240 of SEQ ID NO: 2 to amino acids 764 to 1250 of SEQ ID NO: 2), up to about 15 amino acids (e.g., any sequences from amino acids 764 to 1240 of SEQ ID NO: 2 to amino acids 764 to 1255 of SEQ ID NO: 2), up to about 20 amino acids (e.g., any sequences from amino acids 764 to 1240 of SEQ ID NO: 2 to amino acids 764 to 1260 of SEQ ID NO: 2), up to about 25 amino acids (e.g., any sequences from amino acids 764 to 1240 of SEQ ID NO: 2 to amino acids 764 to 1265 of SEQ ID NO: 2), or up to about 30 amino acids (e.g.,
  • the VWF fragment comprising the D'D3 domains linked to the D1D2 domains further comprises an intracellular cleavage site, e.g., (a cleavage site by PACE or PC5), allowing cleavage of the D1D2 domains from the D'D3 domains upon expression.
  • an intracellular cleavage site e.g., (a cleavage site by PACE or PC5).
  • a VWF fragment comprises the D' domain and the D3 domain, but does not comprise an amino acid sequence selected from the group consisting of (1) amino acids 1241 to 2813 of SEQ ID NO: 2, (2) amino acids 1270 to amino acids 2813 of SEQ ID NO: 2, (3) amino acids 1271 to amino acids 2813 of SEQ ID NO: 2, (4) amino acids 1272 to amino acids 2813 of SEQ ID NO: 2, (5) amino acids 1273 to amino acids 2813 of SEQ ID NO: 2, and (6) amino acids 1274 to amino acids 2813 of SEQ ID NO: 2.
  • a VWF fragment of the present invention comprises, consists essentially of, or consists of an amino acid sequence corresponding to the D' domain, D3 domain, and Al domain, wherein the amino acid sequence is at least 60%, 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99%, or 100% identical to amino acid 764 to 1479 of SEQ ID NO: 2, wherein the VWF binds to FVIII.
  • the VWF fragment is not amino acids 764 to 1274 of SEQ ID NO: 2.
  • a VWF fragment of the invention comprises the D' domain and the D3 domain, but does not comprise at least one VWF domain selected from the group consisting of (1) an Al domain, (2) an A2 domain, (3) an A3 domain, (4) a D4 domain, (5) a Bl domain, (6) a B2 domain, (7) a B3 domain, (8) a CI domain, (9) a C2 domain, (10) a CK domain, (11) a CK domain and C2 domain, (12) a CK domain, a C2 domain, and a CI domain, (13) a CK domain, a C2 domain, a CI domain, a B3 domain, (14) a CK domain, a C2 domain, a CI domain, a B3 domain, a B2 domain, (15) a CK domain, a C2 domain, a CI domain, a B3 domain, a B2 domain, (15) a CK domain, a C2 domain, a CI domain, a
  • the VWF fragment comprises the D'D3 domains and one or more domains or modules.
  • domains or modules include, but are not limited to, the domains and modules disclosed in Zhour et al, Blood published online April 6, 2012: DOI 10.1182/blood-2012-01-405134.
  • the VWF fragment can comprise the D'D3 domain and one or more domains or modules selected from the group consisting of Al domain, A2 domain, A3 domain, D4N module, VWD4 module, C8-4 module, TIL-4 module, CI module, C2 module, C3 module, C4 module, C5 module, C5 module, C6 module, and any combinations thereof.
  • the VWF fragment is linked to a heterologous moiety, wherein the heterologous moiety is linked to the N-terminus or the C-terminus of the VWF fragment or inserted between two amino acids in the VWF fragment.
  • the insertion sites for the heterologous moiety in the VWF fragment can be in the D' domain, the D3 domain, or both.
  • the heterologous moiety can be a half-life extender.
  • a VWF fragment of the invention forms a multimer, e.g., dimer, trimer, tetramer, pentamer, hexamer, heptamer, or the higher order multimers.
  • the VWF fragment is a monomer having only one VWF fragment.
  • the VWF fragment of the present invention can have one or more amino acid substitutions, deletions, additions, or modifications.
  • the VWF fragment can include amino acid substitutions, deletions, additions, or modifications such that the VWF fragment is not capable of forming a disulfide bond or forming a dimer or a multimer.
  • the amino acid substitution is within the D' domain and the D3 domain.
  • a VWF fragment of the invention contains at least one amino acid substitution at a residue corresponding to residue 1099, residue 1142, or both residues 1099 and 1142 of SEQ ID NO: 2.
  • the at least one amino acid substitution can be any amino acids that are not occurring naturally in the wild type VWF.
  • the amino acid substitution can be any amino acids other than cysteine, e.g., Isoleucine, Alanine, Leucine, Asparagine, Lysine, Aspartic acid, Methionine, Phenylalanine, Glutamic acid, Threonine, Glutamine, Tryptophan, Glycine, Valine, Proline, Serine, Tyrosine, Arginine, or Histidine.
  • the amino acid substitution has one or more amino acids that prevent or inhibit the VWF fragments from forming multimers.
  • the VWF fragment useful herein can be further modified to improve its interaction with FVIII, e.g., to improve binding affinity to FVIII.
  • the VWF fragment comprises a serine residue at the residue corresponding to amino acid 764 of SEQ ID NO: 2 and a lysine residue at the residue corresponding to amino acid 773 of SEQ ID NO: 2. Residues 764 and/or 773 can contribute to the binding affinity of the VWF fragments to FVIII.
  • the VWF fragment can have other modifications, e.g., the fragment can be pegylated, glycosylated, hesylated, or polysialylated.
  • the heterologous moiety can be a heterologous polypeptide or a heterologous non-polypeptide moiety.
  • the heterologous moiety is a half-life extending molecule which is known in the art and comprises a polypeptide, a non- polypeptide moiety, or the combination of both.
  • the heterologous polypeptide moiety can comprise an immunoglobulin constant region or a portion thereof, albumin or a fragment thereof, an albumin binding moiety, transferrin or a fragment thereof, a PAS sequence, a HAP sequence, a derivative or variant thereof, or any combinations thereof.
  • the non-polypeptide binding moiety comprises polyethylene glycol (PEG), polysialic acid, hydroxyethyl starch (HES), a derivative thereof, or any combinations thereof.
  • PEG polyethylene glycol
  • HES hydroxyethyl starch
  • An immunoglobulin constant region is comprised of domains denoted CH
  • constant heavy domains CHI, CH2, etc.
  • the constant region can be comprised of three or four CH domains.
  • Some isotypes (e.g. IgG) constant regions also contain a hinge region. See Janeway et al. 2001, Immunobiology, Garland Publishing, N.Y., N.Y.
  • an immunoglobulin constant region or a portion thereof for producing the chimeric protein of the present invention may be obtained from a number of different sources.
  • an immunoglobulin constant region or a portion thereof is derived from a human immunoglobulin. It is understood, however, that the immunoglobulin constant region or a portion thereof may be derived from an immunoglobulin of another mammalian species, including for example, a rodent (e.g. a mouse, rat, rabbit, guinea pig) or non-human primate (e.g. chimpanzee, macaque) species.
  • rodent e.g. a mouse, rat, rabbit, guinea pig
  • non-human primate e.g. chimpanzee, macaque
  • the immunoglobulin constant region or a portion thereof may be derived from any immunoglobulin class, including IgM, IgG, IgD, IgA and IgE, and any immunoglobulin isotype, including IgGl, IgG2, IgG3 and IgG4.
  • the human isotype IgGl is used.
  • immunoglobulin constant region gene sequences e.g. human constant region gene sequences
  • Constant region domains sequence can be selected having a particular effector function (or lacking a particular effector function) or with a particular modification to reduce immunogenicity.
  • Many sequences of antibodies and antibody-encoding genes have been published and suitable Ig constant region sequences (e.g. hinge, CH2, and/or CH3 sequences, or portions thereof) can be derived from these sequences using art recognized techniques.
  • the genetic material obtained using any of the foregoing methods may then be altered or synthesized to obtain polypeptides of the present invention. It will further be appreciated that the scope of this invention encompasses alleles, variants and mutations of constant region DNA sequences.
  • sequences of the immunoglobulin constant region or a portion thereof can be cloned, e.g., using the polymerase chain reaction and primers which are selected to amplify the domain of interest.
  • mRNA can be isolated from hybridoma, spleen, or lymph cells, reverse transcribed into DNA, and antibody genes amplified by PCR.
  • PCR amplification methods are described in detail in U.S. Pat. Nos. 4,683,195; 4,683,202; 4,800,159; 4,965,188; and in, e.g., "PCR Protocols: A Guide to Methods and Applications" Innis et al.
  • PCR may be initiated by consensus constant region primers or by more specific primers based on the published heavy and light chain DNA and amino acid sequences. As discussed above, PCR also may be used to isolate DNA clones encoding the antibody light and heavy chains. In this case the libraries may be screened by consensus primers or larger homologous probes, such as mouse constant region probes. Numerous primer sets suitable for amplification of antibody genes are known in the art (e.g., 5' primers based on the N-terminal sequence of purified antibodies (Benhar and Pastan. 1994.
  • An immunoglobulin constant region used herein can include all domains and the hinge region or portions thereof.
  • the immunoglobulin constant region or a portion thereof comprises CH2 domain, CH3 domain, and a hinge region, i.e., an Fc region or an FcRn binding partner.
  • Fc region is defined as the portion of a polypeptide which corresponds to the Fc region of native immunoglobulin, i.e., as formed by the dimeric association of the respective Fc domains of its two heavy chains.
  • a native Fc region forms a homodimer with another Fc region.
  • scFc region single-chain Fc region
  • scFc region refers to a synthetic dimeric Fc region comprised of Fc domains genetically linked within a single polypeptide chain (i.e., encoded in a single contiguous genetic sequence).
  • the "Fc region” refers to the portion of a single immunoglobulin heavy chain beginning in the hinge region just upstream of the papain cleavage site (i.e. residue 216 in IgG, taking the first residue of heavy chain constant region to be 114) and ending at the C-terminus of the antibody. Accordingly, a complete Fc domain comprises at least a hinge domain, a CH2 domain, and a CH3 domain.
  • the Fc region of an immunoglobulin constant region can include the CH2, CH3, and CH4 domains, as well as the hinge region.
  • Chimeric proteins comprising an Fc region of an immunoglobulin bestow several desirable properties on a chimeric protein including increased stability, increased serum half-life (see Capon et ah, 1989, Nature 337:525) as well as binding to Fc receptors such as the neonatal Fc receptor (FcRn) (U.S. Pat. Nos. 6,086,875, 6,485,726, 6,030,613; WO 03/077834; US2003-0235536A1), which are incorporated herein by reference in their entireties.
  • FcRn neonatal Fc receptor
  • An immunoglobulin constant region or a portion thereof can be an FcRn binding partner.
  • FcRn is active in adult epithelial tissues and expressed in the lumen of the intestines, pulmonary airways, nasal surfaces, vaginal surfaces, colon and rectal surfaces (U.S. Pat. No. 6,485,726).
  • An FcRn binding partner is a portion of an immunoglobulin that binds to FcRn.
  • the FcRn receptor has been isolated from several mammalian species including humans. The sequences of the human FcRn, monkey FcRn, rat FcRn, and mouse FcRn are known (Story et al. 1994, J. Exp. Med. 180:2377).
  • the FcRn receptor binds IgG (but not other immunoglobulin classes such as IgA, IgM, IgD, and IgE) at relatively low pH, actively transports the IgG transcellularly in a luminal to serosal direction, and then releases the IgG at relatively higher pH found in the interstitial fluids. It is expressed in adult epithelial tissue (U.S. Pat. Nos.
  • FcRn binding partners useful in the present invention encompass molecules that can be specifically bound by the FcRn receptor including whole IgG, the Fc fragment of IgG, and other fragments that include the complete binding region of the FcRn receptor.
  • the region of the Fc portion of IgG that binds to the FcRn receptor has been described based on X-ray crystallography (Burmeister et al. 1994, Nature 372:379).
  • the major contact area of the Fc with the FcRn is near the junction of the CH2 and CH3 domains. Fc-FcRn contacts are all within a single Ig heavy chain.
  • the FcRn binding partners include whole IgG, the Fc fragment of IgG, and other fragments of IgG that include the complete binding region of FcRn.
  • the major contact sites include amino acid residues 248, 250-257, 272, 285, 288, 290-291, 308-311, and 314 of the CH2 domain and amino acid residues 385-387, 428, and 433-436 of the CH3 domain.
  • References made to amino acid numbering of immunoglobulins or immunoglobulin fragments, or regions, are all based on Kabat et al. 1991, Sequences of Proteins of Immunological Interest, U.S. Department of Public Health, Bethesda, Md.
  • Fc regions or FcRn binding partners bound to FcRn can be effectively shuttled across epithelial barriers by FcRn, thus providing a non-invasive means to systemically administer a desired therapeutic molecule.
  • fusion proteins comprising an Fc region or an FcRn binding partner are endocytosed by cells expressing the FcRn. But instead of being marked for degradation, these fusion proteins are recycled out into circulation again, thus increasing the in vivo half-life of these proteins.
  • the portions of immunoglobulin constant regions are an Fc region or an FcRn binding partner that typically associates, via disulfide bonds and other non-specific interactions, with another Fc region or another FcRn binding partner to form dimers and higher order multimers.
  • FcRn receptors can bind a single Fc molecule. Crystallographic data suggest that each FcRn molecule binds a single polypeptide of the Fc homodimer.
  • linking the FcRn binding partner, e.g., an Fc fragment of an IgG, to a biologically active molecule provides a means of delivering the biologically active molecule orally, buccally, sublingually, rectally, vaginally, as an aerosol administered nasally or via a pulmonary route, or via an ocular route.
  • the chimeric protein can be administered invasively, e.g., subcutaneously, intravenously.
  • An FcRn binding partner region is a molecule or a portion thereof that can be specifically bound by the FcRn receptor with consequent active transport by the FcRn receptor of the Fc region.
  • Specifically bound refers to two molecules forming a complex that is relatively stable under physiologic conditions. Specific binding is characterized by a high affinity and a low to moderate capacity as distinguished from nonspecific binding which usually has a low affinity with a moderate to high capacity. Typically, binding is considered specific when the affinity constant KA is higher than 10 6 M "1 , or higher than 10 8 M "1 . If necessary, non-specific binding can be reduced without substantially affecting specific binding by varying the binding conditions.
  • the appropriate binding conditions such as concentration of the molecules, ionic strength of the solution, temperature, time allowed for binding, concentration of a blocking agent (e.g. serum albumin, milk casein), etc., may be optimized by a skilled artisan using routine techniques.
  • a chimeric protein of the invention comprises one or more truncated Fc regions that are nonetheless sufficient to confer Fc receptor (FcR) binding properties to the Fc region.
  • the portion of an Fc region that binds to FcRn comprises from about amino acids 282-438 of IgGl, EU numbering (with the primary contact sites being amino acids 248, 250-257, 272, 285, 288, 290-291, 308-311, and 314 of the CH2 domain and amino acid residues 385-387, 428, and 433-436 of the CH3 domain.
  • an Fc region of the invention may comprise or consist of an FcRn binding portion.
  • FcRn binding portions may be derived from heavy chains of any isotype, including IgGl, IgG2, IgG3 and IgG4. In one embodiment, an FcRn binding portion from an antibody of the human isotype IgGl is used. In another embodiment, an FcRn binding portion from an antibody of the human isotype IgG4 is used.
  • the "Fc region” includes an amino acid sequence of an Fc domain or derived from an Fc domain.
  • an Fc region comprises at least one of: a hinge (e.g., upper, middle, and/or lower hinge region) domain (about amino acids 216-230 of an antibody Fc region according to EU numbering), a CH2 domain (about amino acids 231-340 of an antibody Fc region according to EU numbering), a CH3 domain (about amino acids 341-438 of an antibody Fc region according to EU numbering), a CH4 domain, or a variant, portion, or fragment thereof.
  • an Fc region comprises a complete Fc domain (i.e., a hinge domain, a CH2 domain, and a CH3 domain).
  • an Fc region comprises, consists essentially of, or consists of a hinge domain (or a portion thereof) fused to a CH3 domain (or a portion thereof), a hinge domain (or a portion thereof) fused to a CH2 domain (or a portion thereof), a CH2 domain (or a portion thereof) fused to a CH3 domain (or a portion thereof), a CH2 domain (or a portion thereof) fused to both a hinge domain (or a portion thereof) and a CH3 domain (or a portion thereof).
  • an Fc region lacks at least a portion of a CH2 domain (e.g., all or part of a CH2 domain).
  • an Fc region comprises or consists of amino acids corresponding to EU numbers 221 to 447.
  • Fc regions denoted as F, Fl , or F2 herein may be obtained from a number of different sources.
  • an Fc region of the polypeptide is derived from a human immunoglobulin. It is understood, however, that an Fc region may be derived from an immunoglobulin of another mammalian species, including for example, a rodent (e.g. a mouse, rat, rabbit, guinea pig) or non-human primate (e.g. chimpanzee, macaque) species.
  • rodent e.g. a mouse, rat, rabbit, guinea pig
  • non-human primate e.g. chimpanzee, macaque
  • polypeptide of the Fc domains or portions thereof may be derived from any immunoglobulin class, including IgM, IgG, IgD, IgA and IgE, and any immunoglobulin isotype, including IgGl, IgG2, IgG3 and IgG4.
  • immunoglobulin class including IgM, IgG, IgD, IgA and IgE
  • immunoglobulin isotype including IgGl, IgG2, IgG3 and IgG4.
  • the human isotype IgGl is used.
  • the Fc variant confers a change in at least one effector function imparted by an Fc region comprising said wild-type Fc domain (e.g., an improvement or reduction in the ability of the Fc region to bind to Fc receptors (e.g. FcyRI, FcyRII, or FcyRIII) or complement proteins (e.g. C lq), or to trigger antibody- dependent cytotoxicity (ADCC), phagocytosis, or complement-dependent cytotoxicity (CDCC)).
  • Fc receptors e.g. FcyRI, FcyRII, or FcyRIII
  • complement proteins e.g. C lq
  • ADCC antibody- dependent cytotoxicity
  • phagocytosis phagocytosis
  • CDC complement-dependent cytotoxicity
  • the Fc variant provides an engineered cysteine residue.
  • the Fc regions of the invention may employ art-recognized Fc variants which are known to impart a change (e.g., an enhancement or reduction) in effector function and/or FcR or FcRn binding.
  • a binding molecule of the invention may include, for example, a change (e.g., a substitution) at one or more of the amino acid positions disclosed in International PCT Publications WO88/07089A1, W096/14339A1, WO98/05787A1, W098/23289A1, W099/51642A1, W099/58572A1, WO00/09560A2, WO00/32767A1, WO00/42072A2, WO02/44215A2, WO02/060919A2, WO03/074569A2, WO04/016750A2, WO04/029207A2, WO04/035752A2, WO04/063351A2, WO04/074455A2, WO04
  • the specific change (e.g., the specific substitution of one or more amino acids disclosed in the art) may be made at one or more of the disclosed amino acid positions.
  • a different change at one or more of the disclosed amino acid positions (e.g., the different substitution of one or more amino acid position disclosed in the art) may be made.
  • the Fc region or FcRn binding partner of IgG can be modified according to well recognized procedures such as site directed mutagenesis and the like to yield modified IgG or Fc fragments or portions thereof that will be bound by FcRn.
  • modifications include modifications remote from the FcRn contact sites as well as modifications within the contact sites that preserve or even enhance binding to the FcRn.
  • Fc ⁇ the following single amino acid residues in human IgGl Fc (Fc ⁇ ) can be substituted without significant loss of Fc binding affinity for FcRn: P238A, S239A, K246A, K248A, D249A, M252A, T256A, E258A, T260A, D265A, S267A, H268A, E269A, D270A, E272A, L274A, N276A, Y278A, D280A, V282A, E283A, H285A, N286A, T289A, K290A, R292A, E293A, E294A, Q295A, Y296F, N297A, S298A, Y300F, R301A, V303A, V305A, T307A, L309A, Q311A, D312A, N315A, K317A, E318A, K320
  • a specific embodiment incorporates the N297A mutation, removing a highly conserved N-glycosylation site.
  • N297A mutation may be substituted for the wild type amino acids at the positions specified above. Mutations may be introduced singly into Fc giving rise to more than one hundred Fc regions distinct from the native Fc. Additionally, combinations of two, three, or more of these individual mutations may be introduced together, giving rise to hundreds more Fc regions.
  • one of the Fc region of a construct of the invention may be mutated and the other Fc region of the construct not mutated at all, or they both may be mutated but with different mutations.
  • Certain of the above mutations may confer new functionality upon the Fc region or FcRn binding partner.
  • one embodiment incorporates N297A, removing a highly conserved N-glycosylation site. The effect of this mutation is to reduce immunogenicity, thereby enhancing circulating half-life of the Fc region, and to render the Fc region incapable of binding to FcyRI, FcyRIIA, FcyRIIB, and FcyRIIIA, without compromising affinity for FcRn (Routledge et al. 1995, Transplantation 60:847; Friend et al. 1999, Transplantation 68:1632; Shields et al. 1995, J. Biol. Chem. 276:6591).
  • affinity for FcRn may be increased beyond that of wild type in some instances. This increased affinity may reflect an increased "on” rate, a decreased “off rate or both an increased “on” rate and a decreased "off rate.
  • mutations believed to impart an increased affinity for FcRn include, but not limited to, T256A, T307A, E380A, and N434A (Shields et al. 2001, J. Biol. Chem. 276:6591).
  • At least three human Fc gamma receptors appear to recognize a binding site on IgG within the lower hinge region, generally amino acids 234-237. Therefore, another example of new functionality and potential decreased immunogenicity may arise from mutations of this region, as for example by replacing amino acids 233-236 of human IgGl "ELLG” to the corresponding sequence from IgG2 "PVA" (with one amino acid deletion). It has been shown that FcyRI, FcyRII, and FcyRIII, which mediate various effector functions will not bind to IgGl when such mutations have been introduced. Ward and Ghetie 1995, Therapeutic Immunology 2:77 and Armour et al. 1999, Eur. J. Immunol. 29:2613.
  • the immunoglobulin constant region or a portion thereof, e.g, an Fc region is a polypeptide including the sequence PK SSMISNTP (SEQ ID NO: 3) and optionally further including a sequence selected from HQSLGTQ (SEQ ID NO: 4), HQNLSDGK (SEQ ID NO: 5), HQNISDGK (SEQ ID NO: 6), or VISSHLGQ (SEQ ID NO: 7) (U.S. Pat. No. 5,739,277).
  • the immunoglobulin constant region or a portion thereof comprises an amino acid sequence in the hinge region or a portion thereof that forms one or more disulfide bonds with another immunoglobulin constant region or a portion thereof.
  • the disulfide bond by the immunoglobulin constant region or a portion thereof places the first polypeptide comprising FVIII and the second polypeptide comprising the VWF fragment together so that endogenous VWF does not replace the VWF fragment and does not bind to the FVIII. Therefore, the disulfide bond between the first immunoglobulin constant region or a portion thereof and a second immunoglobulin constant region or a portion thereof prevents interaction between endogenous VWF and the FVIII protein.
  • an immunoglobulin constant region or a portion thereof comprises a hinge region and CH2 region (e.g., amino acids 221-340 of an Fc region).
  • the immunoglobulin constant region or a portion thereof is hemi-glycosylated.
  • the chimeric protein comprising two Fc regions or FcRn binding partners may contain a first, glycosylated, Fc region (e.g., a glycosylated CH2 region) or FcRn binding partner and a second, aglycosylated, Fc region (e.g., an aglycosylated CH2 region) or FcRn binding partner.
  • a linker may be interposed between the glycosylated and aglycosylated Fc regions.
  • the Fc region or FcRn binding partner is fully glycosylated, i.e., all of the Fc regions are glycosylated.
  • the Fc region may be aglycosylated, i.e., none of the Fc moieties are glycosylated.
  • a chimeric protein of the invention comprises an amino acid substitution to an immunoglobulin constant region or a portion thereof (e.g., Fc variants), which alters the antigen-independent effector functions of the Ig constant region, in particular the circulating half-life of the protein.
  • Such proteins exhibit either increased or decreased binding to FcRn when compared to proteins lacking these substitutions and, therefore, have an increased or decreased half-life in serum, respectively.
  • Fc variants with improved affinity for FcRn are anticipated to have longer serum half-lives, and such molecules have useful applications in methods of treating mammals where long half-life of the administered polypeptide is desired, e.g., to treat a chronic disease or disorder (see, e.g, US Patents 7,348,004, 7,404,956, and 7,862,820).
  • Fc variants with decreased FcRn binding affinity are expected to have shorter half-lives, and such molecules are also useful, for example, for administration to a mammal where a shortened circulation time may be advantageous, e.g.
  • the chimeric protein of the invention exhibit reduced transport across the epithelium of kidney glomeruli from the vasculature. In another embodiment, the chimeric protein of the invention exhibit reduced transport across the blood brain barrier (BBB) from the brain, into the vascular space.
  • BBB blood brain barrier
  • a protein with altered FcRn binding comprises at least one Fc region or FcRn binding partner (e.g, one or two Fc regions or FcRn binding partners) having one or more amino acid substitutions within the "FcRn binding loop" of an Ig constant region.
  • the FcRn binding loop is comprised of amino acid residues 280-299 (according to EU numbering) of a wild-type, full-length, Fc region.
  • an Ig constant region or a portion thereof in a chimeric protein of the invention having altered FcRn binding affinity comprises at least one Fc region or FcRn binding partner having one or more amino acid substitutions within the 15 A FcRn "contact zone.”
  • 15 A FcRn "contact zone” includes residues at the following positions of a wild- type, full-length Fc moiety: 243-261 , 275-280, 282-293, 302-319, 336- 348, 367, 369, 372-389, 391 , 393, 408, 424, 425-440 (EU numbering).
  • a Ig constant region or a portion thereof of the invention having altered FcRn binding affinity comprises at least one Fc region or FcRn binding partner having one or more amino acid substitutions at an amino acid position corresponding to any one of the following EU positions: 256, 277-281 , 283-288, 303-309, 313, 338, 342, 376, 381 , 384, 385, 387, 434 (e.g., N434A or N434K), and 438.
  • Exemplary amino acid substitutions which altered FcRn binding activity are disclosed in International PCT Publication No. WO05/047327 which is incorporated by reference herein.
  • an Fc region or FcRn binding partner used in the invention may also comprise an art recognized amino acid substitution which alters the glycosylation of the chimeric protein.
  • the Fc region or FcRn binding partner of the chimeric protein linked to a VWF fragment or a FVIII protein may comprise an Fc region having a mutation leading to reduced glycosylation (e.g., N- or O-linked glycosylation) or may comprise an altered glycoform of the wild-type Fc moiety (e.g. , a low fucose or fucose- free glycan).
  • an unprocessed chimeric protein of the invention may comprise a genetically fused Fc region (i.e., scFc region) having two or more of its constituent Ig constant region or a portion thereof independently selected from the Ig constant region or a portion thereof described herein.
  • Fc regions of a dimeric Fc region are the same. In another embodiment, at least two of the Fc regions are different.
  • the Fc regions or FcRn binding partners of the proteins of the invention comprise the same number of amino acid residues or they may differ in length by one or more amino acid residues (e.g., by about 5 amino acid residues (e.g., 1 , 2, 3, 4, or 5 amino acid residues), about 10 residues, about 15 residues, about 20 residues, about 30 residues, about 40 residues, or about 50 residues).
  • the Fc regions or FcRn binding partners of the protein of the invention may differ in sequence at one or more amino acid positions.
  • At least two of the Fc regions or FcRn binding partners may differ at about 5 amino acid positions (e.g., 1 , 2, 3, 4, or 5 amino acid positions), about 10 positions, about 15 positions, about 20 positions, about 30 positions, about 40 positions, or about 50 positions).
  • Albumin or fragment, or variant thereof e.g., 1 , 2, 3, 4, or 5 amino acid positions
  • the heterologous moiety linked to the VWF fragment or linked to a FVIII protein is albumin or a functional fragment thereof.
  • a chimeric protein of the invention comprises a FVIII protein and albumin or a fragment thereof, wherein the albumin or a fragment thereof shields or protects the VWF binding site on the FVIII protein, thereby inhibiting or preventing interaction of the FVIII protein with endogenous VWF.
  • HSA Human serum albumin
  • HA Human serum albumin
  • the chimeric protein comprises the VWF fragment described herein and albumin, fragment, or variant thereof, wherein the VWF fragment is linked to albumin or a fragment or variant thereof.
  • the chimeric protein comprises the VWF fragment and a FVIII protein, which are bound to each other, wherein the VWF fragment is linked to albumin or a fragment or variant thereof, the protein having VIII activity is linked to albumin or a fragment or variant thereof, or both the VWF fragment and the protein having VIII activity are linked to albumin or a fragment or variant thereof.
  • the chimeric protein comprises the VWF fragment linked to albumin or a fragment or variant thereof is further linked to a heterologous moiety selected from the group consisting of an immunoglobulin constant region or a portion thereof (e.g., an Fc region), a PAS sequence, HES, and PEG.
  • the chimeric protein comprises the VWF fragment and a FVIII protein, which are bound to each other, wherein the FVIII protein is linked to albumin or a fragment or variant thereof and further linked to a heterologous moiety selected from the group consisting of an immunoglobulin constant region or a portion thereof (e.g., an Fc region), a PAS sequence, HES, and PEG.
  • the chimeric protein comprises the VWF fragment linked to albumin or a fragment or variant thereof and a FVIII protein linked to albumin or a fragment or variant thereof, which are bound to each other, wherein the VWF fragment activity is further linked to a first heterologous moiety selected from the group consisting of an immunoglobulin constant region or a portion thereof (e.g., an Fc region), a PAS sequence, HES, and PEG and wherein the FVIII protein activity is further linked to a second heterologous moiety selected from the group consisting of an immunoglobulin constant region or a portion thereof (e.g., an Fc region), a PAS sequence, HES, and PEG.
  • a first heterologous moiety selected from the group consisting of an immunoglobulin constant region or a portion thereof (e.g., an Fc region), a PAS sequence, HES, and PEG
  • FVIII protein activity is further linked to a second heterologous moiety selected from the group consisting of an immunoglobul
  • FVIII protein is albumin or a fragment or variant thereof, which extends (or is capable of extending) the half-life of the VWF fragment or the FVIII protein.
  • Further examples of albumin or the fragments or variants thereof are disclosed in US Pat. Publ. Nos. 2008/0194481A1, 2008/0004206 Al, 2008/0161243 Al, 2008/0261877 Al, or 2008/0153751 Al or PCT Appl. Publ. Nos. 2008/033413 A2, 2009/058322 Al, or 2007/021494 A2.
  • the heterologous moiety linked to the VWF fragment or the FVIII protein is an albumin binding moiety, which comprises an albumin binding peptide, a bacterial albumin binding domain, an albumin-binding antibody fragment, or any combinations thereof.
  • the albumin binding protein can be a bacterial albumin binding protein, an antibody or an antibody fragment including domain antibodies (see U.S. Pat. No. 6,696,245).
  • An albumin binding protein for example, can be a bacterial albumin binding domain, such as the one of streptococcal protein G (Konig, T. and Skerra, A. (1998) J. Immunol. Methods 218, 73-83).
  • albumin binding peptides that can be used as conjugation partner are, for instance, those having a Cys-Xaa i -Xaa 2 -Xaa 3 -Xaa 4 -Cys consensus sequence, wherein Xaa 1 is Asp, Asn, Ser, Thr, or Trp; Xaa 2 is Asn, Gin, H is, He, Leu, or Lys; Xaa 3 is Ala, Asp, Phe, Trp, or Tyr; and Xaa 4 is Asp, Gly, Leu, Phe, Ser, or Thr as described in US patent application 2003/0069395 or Dennis et al. (Dennis et al. (2002) J. Biol. Chem. 277, 35035-35043).
  • the heterologous moiety linked to the VWF fragment or to the FVIII protein is a PAS sequence.
  • the chimeric protein comprises a VWF fragment described herein and a PAS sequence, wherein the VWF fragment is linked to the PAS sequence.
  • a chimeric protein of the invention comprises a FVIII protein and a PAS sequence, wherein the PAS sequence shields or protects the VWF binding site on the FVIII protein, thereby inhibiting or preventing interaction of the FVIII protein with endogenous VWF.
  • a PAS sequence means an amino acid sequence comprising mainly alanine and serine residues or comprising mainly alanine, serine, and proline residues, the amino acid sequence forming random coil conformation under physiological conditions.
  • the PAS sequence is a building block, an amino acid polymer, or a sequence cassette comprising, consisting essentially of, or consisting of alanine, serine, and proline which can be used as a part of the heterologous moiety in the chimeric protein.
  • an amino acid polymer also may form random coil conformation when residues other than alanine, serine, and proline are added as a minor constituent in the PAS sequence.
  • minor constituent means that amino acids other than alanine, serine, and proline may be added in the PAS sequence to a certain degree, e.g., up to about 12%, i.e., about 12 of 100 amino acids of the PAS sequence, up to about 10%, i.e.
  • about 10 of 100 amino acids of the PAS sequence up to about 9%, i.e., about 9 of 100 amino acids, up to about 8%, i.e., about 8 of 100 amino acids, about 6%, i.e., about 6 of 100 amino acids, about 5%, i.e., about 5 of 100 amino acids, about 4%, i.e., about 4 of 100 amino acids, about 3%, i.e., about 3 of 100 amino acids, about 2%, i.e., about 2 of 100 amino acids, about 1%, i.e., about 1 of 100 of the amino acids.
  • amino acids different from alanine, serine and proline may be selected from the group consisting of Arg, Asn, Asp, Cys, Gin, Glu, Gly, His, He, Leu, Lys, Met, Phe, Thr, Trp, Tyr, and Val.
  • the PAS sequence stretch forms a random coil conformation and thereby can mediate an increased in vivo and/or in vitro stability to the VWF factor or the protein of coagulation activity. Since the random coil domain does not adopt a stable structure or function by itself, the biological activity mediated by the VWF fragment or the FVIII protein to which it is fused is essentially preserved.
  • the PAS sequences that form random coil domain are biologically inert, especially with respect to proteolysis in blood plasma, immunogenicity, isoelectric point/electrostatic behavior, binding to cell surface receptors or internalization, but are still biodegradable, which provides clear advantages over synthetic polymers such as PEG.
  • Non-limiting examples of the PAS sequences forming random coil conformation comprise an amino acid sequence selected from the group consisting of ASPAAPAPASPAAPAPSAPA (SEQ ID NO: 8), AAPASPAPAAPSAPAPAAPS (SEQ ID NO: 9), APSSPSPSAPSSPSPASPSS (SEQ ID NO: 10), APSSPSPSAPSSPSPASPS (SEQ ID NO: 11), SSPSAPSPSSPASPSPSSPA (SEQ ID NO: 12), AASPAAPSAPPAAASPAAPSAPPA (SEQ ID NO: 13) and AS AAAP AAAS AAAS AP S AAA (SEQ ID NO: 14) or any combinations thereof. Additional examples of PAS sequences are known from, e.g., US Pat. Publ. No. 2010/0292130 Al and PCT Appl. Publ. No. WO 2008/155134 Al .
  • the heterologous moiety linked to the VWF fragment or the FVIII protein is a glycine -rich homo-amino-acid polymer (HAP).
  • HAP sequence can comprise a repetitive sequence of glycine, which has at least 50 amino acids, at least 100 amino acids, 120 amino acids, 140 amino acids, 160 amino acids, 180 amino acids, 200 amino acids, 250 amino acids, 300 amino acids, 350 amino acids, 400 amino acids, 450 amino acids, or 500 amino acids in length.
  • the HAP sequence is capable of extending half-life of a moiety fused to or linked to the HAP sequence.
  • Non- limiting examples of the HAP sequence includes, but are not limited to (Gly) n , (Gly 4 Ser) n or S(Gly 4 Ser) n , wherein n is 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, or 20.
  • n is 20, 21, 22, 23, 24, 25, 26, 26, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, or 40.
  • n is 50, 60, 70, 80, 90, 100, 110, 120, 130, 140, 150, 160, 170, 180, 190, or 200. See, e.g., Schlapschy M et al., Protein Eng. Design Selection, 20: 273-284 (2007).
  • the heterologous moiety linked to the VWF fragment or the FVIII protein is transferrin or a fragment thereof. Any transferrin may be used to make the chimeric proteins of the invention.
  • wild-type human Tf (Tf) is a 679 amino acid protein, of approximately 75 KDa (not accounting for glycosylation), with two main domains, N (about 330 amino acids) and C (about 340 amino acids), which appear to originate from a gene duplication.
  • Transferrin comprises two domains, N domain and C domain.
  • N domain comprises two subdomains, Nl domain and N2 domain
  • C domain comprises two subdomains, CI domain and C2 domain.
  • the transferrin portion of the chimeric protein includes a transferrin splice variant.
  • a transferrin splice variant can be a splice variant of human transferrin, e.g., Genbank Accession AAA61140.
  • the transferrin portion of the chimeric protein includes one or more domains of the transferrin sequence, e.g., N domain, C domain, Nl domain, N2 domain, CI domain, C2 domain or any combinations thereof.
  • the heterologous moiety attached to the VWF fragment or the protein having clotting activity is a soluble polymer known in the art, including, but not limited to, polyethylene glycol, ethylene glycol/propylene glycol copolymers, carboxymethylcellulose, dextran, or polyvinyl alcohol.
  • the heterologous moiety such as soluble polymer can be attached to any positions within the VWF fragment or the FVIII protein or the N- or C- terminus.
  • a chimeric protein of the invention comprises a FVIII protein and PEG, wherein PEG shields or protects the VWF binding site on the FVIII protein, thereby inhibiting or preventing interaction of the FVIII protein with endogenous VWF.
  • the chimeric protein comprises the VWF fragment described herein and PEG, wherein the VWF fragment is linked to PEG.
  • the chimeric protein comprises the VWF fragment and a FVIII protein, which are bound to each other, wherein the VWF fragment is linked to PEG, the FVIII protein is linked to PEG, or both the VWF fragment and the FVIII protein are linked to PEG.
  • the chimeric protein comprising the VWF fragment linked to PEG is further linked to a heterologous moiety selected from the group consisting of an immunoglobulin constant region or a portion thereof (e.g., an Fc region), a PAS sequence, HES, and albumin, fragment, or variant thereof.
  • the chimeric protein comprises the VWF fragment and a FVIII protein, which are bound to each other, wherein the FVIII protein is further linked to a heterologous moiety selected from the group consisting of an immunoglobulin constant region or a portion thereof (e.g., an Fc region), a PAS sequence, HES, and albumin, fragment, or variant thereof.
  • a heterologous moiety selected from the group consisting of an immunoglobulin constant region or a portion thereof (e.g., an Fc region), a PAS sequence, HES, and albumin, fragment, or variant thereof.
  • the chimeric protein comprises the VWF fragment linked to PEG and a FVIII protein linked to PEG, which are bound to each other, wherein the VWF fragment activity is further linked to a first heterologous moiety selected from the group consisting of an immunoglobulin constant region or a portion thereof (e.g., an Fc region), a PAS sequence, HES, and albumin, fragment, or variant thereof and wherein the FVIII protein activity is further linked to a second heterologous moiety selected from the group consisting of an immunoglobulin constant region or a portion thereof (e.g., an Fc region), a PAS sequence, HES, and albumin, fragment, or variant thereof.
  • a first heterologous moiety selected from the group consisting of an immunoglobulin constant region or a portion thereof (e.g., an Fc region), a PAS sequence, HES, and albumin, fragment, or variant thereof.
  • chemically modified derivatives of the chimeric protein of the invention which may provide additional advantages such as increased solubility, stability and circulating time of the polypeptide, or decreased immunogenicity (see U.S. Pat. No. 4,179,337).
  • the chemical moieties for modification can be selected from the group consisting of water soluble polymers including, but not limited to, polyethylene glycol, ethylene glycol/propylene glycol copolymers, carboxymethylcellulose, dextran, and polyvinyl alcohol.
  • the chimeric protein may be modified at random positions within the molecule or at the N- or C- terminus, or at predetermined positions within the molecule and may include one, two, three or more attached chemical moieties.
  • the polymer can be of any molecular weight, and can be branched or unbranched.
  • the molecular weight is between about 1 kDa and about 100 kDa for ease in handling and manufacturing. Other sizes may be used, depending on the desired profile (e.g., the duration of sustained release desired, the effects, if any on biological activity, the ease in handling, the degree or lack of antigenicity and other known effects of the polyethylene glycol to a protein or analog).
  • the polyethylene glycol may have an average molecular weight of about 200, 500, 1000, 1500, 2000, 2500, 3000, 3500, 4000, 4500, 5000, 5500, 6000, 6500, 7000, 7500, 8000, 8500, 9000, 9500, 10,000, 10,500, 11,000, 11,500, 12,000, 12,500, 13,000, 13,500, 14,000, 14,500, 15,000, 15,500, 16,000, 16,500, 17,000, 17,500, 18,000, 18,500, 19,000, 19,500, 20,000, 25,000, 30,000, 35,000, 40,000, 45,000, 50,000, 55,000, 60,000, 65,000, 70,000, 75,000, 80,000, 85,000, 90,000, 95,000, or 100,000 kDa.
  • the polyethylene glycol may have a branched structure.
  • Branched polyethylene glycols are described, for example, in U.S. Pat. No. 5,643,575; Morpurgo et al, Appl. Biochem. Biotechnol. 56:59-72 (1996); Vorobjev et al, Nucleosides Nucleotides 18:2745-2750 (1999); and Caliceti et al., Bioconjug. Chem. 10:638-646 (1999), each of which is incorporated herein by reference in its entirety.
  • VWF fragment, or the FVIII protein of the invention may also vary.
  • the pegylated proteins of the invention may be linked, on average, to 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 12, 15, 17, 20, or more polyethylene glycol molecules.
  • the average degree of substitution within ranges such as 1-3, 2-4, 3-5, 4-6, 5-7, 6-8, 7-9, 8-10, 9-11, 10-12, 11-13, 12-14, 13-15, 14-16, 15-17, 16-18, 17-19, or 18-20 polyethylene glycol moieties per protein molecule.
  • Methods for determining the degree of substitution are discussed, for example, in Delgado et al, Crit. Rev. Thera. Drug Carrier Sys. 9:249-304 (1992).
  • the FVIII protein may be PEGylated.
  • PEGylated Factor PEGylated Factor
  • VIII can refer to a conjugate formed between Factor VIII and at least one polyethylene glycol (PEG) molecule.
  • PEG polyethylene glycol
  • a FVIII protein used in the invention is conjugated to one or more polymers.
  • the polymer can be water-soluble and covalently or non-covalently attached to Factor VIII or other moieties conjugated to Factor VIII.
  • Non- limiting examples of the polymer can be poly(alkylene oxide), poly(vinyl pyrrolidone), poly(vinyl alcohol), polyoxazoline, or poly(acryloylmorpholine). Additional types of polymer- conjugated FVIII are disclosed in U.S. Patent No. 7,199,223.
  • the heterologous moiety linked to the VWF fragment or the FVIII protein is a polymer, e.g., hydroxyethyl starch (HES) or a derivative thereof.
  • a chimeric protein comprises a VWF fragment described herein and HES, wherein the VWF fragment is linked to HES.
  • a chimeric protein of the invention comprises a FVIII protein fused to hydroxyethyl starch (HES), wherein the hydroxyethyl starch or a derivative thereof shields or protects the VWF binding site on the FVIII protein from endogenous VWF, thereby inhibiting or preventing interaction of the FVIII protein with endogenous VWF.
  • HES Hydroxyethyl starch
  • HES is a derivative of naturally occurring amylopectin and is degraded by alpha-amylase in the body.
  • HES is a substituted derivative of the carbohydrate polymer amylopectin, which is present in corn starch at a concentration of up to 95% by weight.
  • HES exhibits advantageous biological properties and is used as a blood volume replacement agent and in hemodilution therapy in the clinics (Sommermeyer et al., Whypharmazie, 8(8), 271-278 (1987); and Weidler et al., Arzneim.-Forschung/Drug Res., 41, 494-498 (1991)).
  • Amylopectin contains glucose moieties, wherein in the main chain alpha- 1,4- glycosidic bonds are present and at the branching sites alpha- 1 ,6-glycosidic bonds are found.
  • the physical-chemical properties of this molecule are mainly determined by the type of glycosidic bonds. Due to the nicked alpha- 1 ,4-glycosidic bond, helical structures with about six glucose-monomers per turn are produced.
  • the physico-chemical as well as the biochemical properties of the polymer can be modified via substitution. The introduction of a hydroxyethyl group can be achieved via alkaline hydroxyethylation.
  • HES is mainly characterized by the molecular weight distribution and the degree of substitution.
  • the degree of substitution denoted as DS, relates to the molar substitution, is known to the skilled people. See Sommermeyer et al., Rohpharmazie, 8(8), 271-278 (1987), as cited above, in particular p. 273.
  • hydroxyethyl starch has a mean molecular weight (weight mean) of from 1 to 300 kD, from 2 to 200kD, from 3 to 100 kD, or from 4 to 70kD.
  • hydroxyethyl starch can further exhibit a molar degree of substitution of from 0.1 to 3, preferably 0.1 to 2, more preferred, 0.1 to 0.9, preferably 0.1 to 0.8, and a ratio between C2:C6 substitution in the range of from 2 to 20 with respect to the hydroxyethyl groups.
  • HES having a mean molecular weight of about 130 kD is a HES with a degree of substitution of 0.2 to 0.8 such as 0.2, 0.3, 0.4, 0.5, 0.6, 0.7, or 0.8, preferably of 0.4 to 0.7 such as 0.4, 0.5, 0.6, or 0.7.
  • HES with a mean molecular weight of about 130 kD is VOLUVEN ® from Fresenius.
  • VOLUVEN ® is an artificial colloid, employed, e.g., for volume replacement used in the therapeutic indication for therapy and prophylaxis of hypovolaemia.
  • VOLUVEN ® are a mean molecular weight of 130,000+/-20,000 D, a molar substitution of 0.4 and a C2:C6 ratio of about 9: 1.
  • ranges of the mean molecular weight of hydroxyethyl starch are, e.g., 4 to 70 kD or 10 to 70 kD or 12 to 70 kD or 18 to 70 kD or 50 to 70 kD or 4 to 50 kD or 10 to 50 kD or 12 to 50 kD or 18 to 50 kD or 4 to 18 kD or 10 to 18 kD or 12 to 18 kD or 4 to 12 kD or 10 to 12 kD or 4 to 10 kD.
  • the mean molecular weight of hydroxyethyl starch employed is in the range of from more than 4 kD and below 70 kD, such as about 10 kD, or in the range of from 9 to 10 kD or from 10 to 11 kD or from 9 to 11 kD, or about 12 kD, or in the range of from 11 to 12 kD) or from 12 to 13 kD or from 1 1 to 13 kD, or about 18 kD, or in the range of from 17 to 18 kD or from 18 to 19 kD or from 17 to 19 kD, or about 30 kD, or in the range of from 29 to 30, or from 30 to 31 kD, or about 50 kD, or in the range of from 49 to 50 kD or from 50 to 51 kD or from 49 to 51 kD.
  • the heterologous moiety can be mixtures of hydroxyethyl starches having different mean molecular weights and/or different degrees of substitution and/or different ratios of C2: C6 substitution. Therefore, mixtures of hydroxyethyl starches may be employed having different mean molecular weights and different degrees of substitution and different ratios of C2: C6 substitution, or having different mean molecular weights and different degrees of substitution and the same or about the same ratio of C2:C6 substitution, or having different mean molecular weights and the same or about the same degree of substitution and different ratios of C2:C6 substitution, or having the same or about the same mean molecular weight and different degrees of substitution and different ratios of C2:C6 substitution, or having different mean molecular weights and the same or about the same degree of substitution and the same or about the same ratio of C2:C6 substitution, or having the same or about the same mean molecular weights and different degrees of substitution and the same ratio of C2:C6 substitution, or having the same or about the same
  • VWF fragment or the FVIII protein is a polymer, e.g., polysialic acids (PSAs) or a derivative thereof.
  • PSAs polysialic acids
  • Polysialic acids (PSAs) are naturally occurring unbranched polymers of sialic acid produced by certain bacterial strains and in mammals in certain cells Roth J., et al. (1993) in Polysialic Acid: From Microbes to Man, eds Roth J., Rutishauser U., Troy F. A. (Birkhauser Verlag, Basel, Switzerland), pp 335- 348..
  • compositions of different polysialic acids also varies such that there are homopolymeric forms i.e. the alpha-2,8-linked polysialic acid comprising the capsular polysaccharide of E. coli strain Kl and the group-B meningococci, which is also found on the embryonic form of the neuronal cell adhesion molecule (N-CAM).
  • N-CAM neuronal cell adhesion molecule
  • Heteropolymeric forms also exist—such as the alternating alpha-2,8 alpha-2,9 polysialic acid of E. coli strain K92 and group C polysaccharides of N. meningitidis.
  • Sialic acid may also be found in alternating copolymers with monomers other than sialic acid such as group W135 or group Y of N. meningitidis.
  • Polysialic acids have important biological functions including the evasion of the immune and complement systems by pathogenic bacteria and the regulation of glial adhesiveness of immature neurons during foetal development (wherein the polymer has an anti-adhesive function) Cho and Troy, P.N.A.S., USA, 91 (1994) 11427-11431, although there are no known receptors for polysialic acids in mammals.
  • the alpha-2,8-linked polysialic acid of E. coli strain Kl is also known as 'colominic acid' and is used (in various lengths) to exemplify the present invention.
  • Various methods of attaching or conjugating polysialic acids to a polypeptide have been described (for example, see U.S. Pat. No. 5,846,951; WO-A-0187922, and US 2007/0191597 Al, which are incorporated herein by reference in their entireties.
  • a FVIII protein as used herein means a functional FVIII polypeptide in its normal role in coagulation, unless otherwise specified.
  • the term a FVIII protein includes a functional fragment, variant, analog, or derivative thereof that retains the function of full-length wild-type Factor VIII in the coagulation pathway.
  • a FVIII protein is used interchangeably with FVIII polypeptide (or protein) or FVIII. Examples of the FVIII functions include, but not limited to, an ability to activate coagulation, an ability to act as a cofactor for factor IX, or an ability to form a tenase complex with factor IX in the presence of Ca2+ and phospholipids, which then converts Factor X to the activated form Xa.
  • the FVIII protein can be the human, porcine, canine, rat, or murine FVIII protein.
  • comparisons between FVIII from humans and other species have identified conserved residues that are likely to be required for function (Cameron et ah, Thromb. Haemost. 79:317-22 (1998); US 6,251,632).
  • a number of tests are available to assess the function of the coagulation system: activated partial thromboplastin time (aPTT) test, chromogenic assay, ROTEM assay, prothrombin time (PT) test (also used to determine INR), fibrinogen testing (often by the Clauss method), platelet count, platelet function testing (often by PFA-100), TCT, bleeding time, mixing test (whether an abnormality corrects if the patient's plasma is mixed with normal plasma), coagulation factor assays, antiphosholipid antibodies, D- dimer, genetic tests (e.g.
  • the aPTT test is a performance indicator measuring the efficacy of both the
  • Intrinsic also referred to the contact activation pathway
  • FIX recombinant clotting factors
  • PT prothrombin time
  • ROTEM analysis provides information on the whole kinetics of haemostasis: clotting time, clot formation, clot stability and lysis.
  • the different parameters in thromboelastometry are dependent on the activity of the plasmatic coagulation system, platelet function, fibrinolysis, or many factors which influence these interactions.
  • This assay can provide a complete view of secondary haemostasis.
  • FVIII polypeptide and polynucleotide sequences are known, as are many functional fragments, mutants and modified versions. Examples of human FVIII sequences (full-length) are shown as subsequences in SEQ ID NO: 16 or 18. Table 2. Full-length FVIII (FVIII signal peptide underlined; FVIII heavy chain is double underlined; B domain is italicized; and FVIII light chain is in plain text)
  • FVIII polypeptides include full-length FVIII, full-length FVIII minus Met at the
  • FVIII variants include B domain deletions, whether partial or full deletions.
  • the human FVIII B-domain is replaced with the human Factor V B-domain as shown in U.S. Pat. No. 5,004,803.
  • the cDNA sequence encoding human Factor VIII and amino acid sequence are shown in SEQ ID NOs: 17 and 16, respectively, of US Application Publ. No. 2005/0100990.
  • porcine FVIII sequence is published in Toole, J. J., et al, Proc. Natl Acad.
  • the FVIII (or FVIII portion of a chimeric protein) may be at least 50%, 60%, 70%, 80%, 90%, 95%, 96%, 97%, 98%, 99%, or 100% identical to a FVIII amino acid sequence of amino acids 1 to 1438 of SEQ ID NO: 18 or amino acids 1 to 2332 of SEQ ID NO: 16 (without a signal sequence) or a FVIII amino acid sequence of amino acids -19 to 1438 of SEQ ID NO: 15 and SEQ ID NO: 18 or amino acids -19 to 2332 of SEQ ID NO: 15 and SEQ ID NO: 16 (with a signal sequence), wherein the FVIII has a clotting activity, e.g., activates Factor IX as a cofactor to convert Factor X to activated Factor X.
  • a clotting activity e.g., activates Factor IX as a cofactor to convert Factor X to activated Factor X.
  • the FVIII (or FVIII portion of a chimeric protein) may be identical to a FVIII amino acid sequence of amino acids 1 to 1438 of SEQ ID NO: 18 or amino acids 1 to 2332 of SEQ ID NO: 16 (without a signal sequence).
  • the FVIII may further comprise a signal sequence.
  • the "B-domain" of FVIII is the same as the B-domain known in the art that is defined by internal amino acid sequence identity and sites of proteolytic cleavage, e.g., residues Ser741-Argl648 of full-length human FVIII.
  • the other human FVIII domains are defined by the following amino acid residues: Al, residues Alal- Arg372; A2, residues Ser373-Arg740; A3, residues Serl690-Asn2019; CI, residues Lys2020-Asn2172; C2, residues Ser2173-Tyr2332.
  • the A3-C1-C2 sequence includes residues Serl690-Tyr2332.
  • BDD FVIII B-domain-deleted factor VIII
  • REFACTO ® recombinant BDD FVIII
  • a "B-domain-deleted FVIII" may have the full or partial deletions disclosed in
  • a B-domain-deleted FVIII sequence of the present invention comprises any one of the deletions disclosed at col. 4, line 4 to col. 5, line 28 and Examples 1-5 of U.S. Pat. No. 6,316,226 (also in US 6,346,513).
  • a B-domain deleted Factor VIII is the S743/Q1638 B-domain deleted Factor VIII (SQ BDD FVIII) (e.g., Factor VIII having a deletion from amino acid 744 to amino acid 1637, e.g., Factor VIII having amino acids 1-743 and amino acids 1638-2332 of SEQ ID NO: 16, i.e., SEQ ID NO: 18).
  • a B-domain-deleted FVIII of the present invention has a deletion disclosed at col. 2, lines 26-51 and examples 5-8 of U.S. Patent No. 5,789,203 (also US 6,060,447, US 5,595,886, and US 6,228,620).
  • a B-domain-deleted Factor VIII has a deletion described in col. 1 , lines 25 to col. 2, line 40 of US Patent No. 5,972,885; col. 6, lines 1-22 and example 1 of U.S. Patent no. 6,048,720; col. 2, lines 17-46 of U.S. Patent No. 5,543,502; col. 4, line 22 to col. 5, line 36 of U.S. Patent no. 5,171,844; col. 2, lines 55-68, figure 2, and example 1 of U.S. Patent No. 5,112,950; col. 2, line 2 to col. 19, line 21 and table 2 of U.S. Patent No. 4,868,112; col. 2, line 1 to col. 3, line 19, col. 3, line 40 to col.
  • a B-domain-deleted FVIII has a deletion of most of the B domain, but still contains amino-terminal sequences of the B domain that are essential for in vivo proteolytic processing of the primary translation product into two polypeptide chain, as disclosed in WO 91/09122.
  • a B-domain-deleted FVIII is constructed with a deletion of amino acids 747-1638, i.e., virtually a complete deletion of the B domain.
  • a B- domain-deleted Factor VIII may also contain a deletion of amino acids 771-1666 or amino acids 868-1562 of FVIII. Meulien P., et al. Protein Eng. 2(4): 301-6 (1988). Additional B domain deletions that are part of the invention include: deletion of amino acids 982 through 1562 or 760 through 1639 (Toole et al, Proc. Natl. Acad. Sci. U.S.A. (1986) 83, 5939-5942)), 797 through 1562 (Eaton, et al.
  • BDD FVIII includes a FVIII polypeptide containing fragments of the B-domain that retain one or more N- linked glycosylation sites, e.g., residues 757, 784, 828, 900, 963, or optionally 943, which correspond to the amino acid sequence of the full-length FVIII sequence.
  • B-domain fragments include 226 amino acids or 163 amino acids of the B-domain as disclosed in Miao, H.Z., et al., Blood 103(a): 3412-3419 (2004), Kasuda, A, et al., J. Thromb. Haemost. 6: 1352-1359 (2008), and Pipe, S.W., et al., J.
  • the FVIII with a partial B-domain is FVIII 198 (SEQ ID NO: 105).
  • FVIII 198 is a partial B-domain containing single chain FVIIIFc molecule- 226N6. 226 represents the N-terminus 226 amino acid of the FVIII B-domain, and N6 represents six N-glycosylation sites in the B-domain.
  • BDD FVIII further comprises a point mutation at residue 309 (from Phe to Ser) to improve expression of the BDD FVIII protein.
  • the BDD FVIII includes a FVIII polypeptide containing a portion of the B-domain, but not containing one or more furin cleavage sites (e.g., Argl313 and Arg 1648). See Pipe, S.W., et al., J. Thromb. Haemost. 9: 2235-2242 (2011). Each of the foregoing deletions may be made in any FVIII sequence.
  • a FVIII protein useful in the present invention can include FVIII having one or more additional heterologous sequences or chemical or physical modifications therein, which do not affect the FVIII coagulation activity.
  • heterologous sequences or chemical or physical modifications can be fused to the C-terminus or N-terminus of the FVIII protein or inserted between one or more of the two amino acid residues in the FVIII protein.
  • Such insertions in the FVIII protein do not affect the FVIII coagulation activity or FVIII function.
  • the insertions improve pharmacokinetic properties of the FVIII protein (e.g., half-life).
  • the insertions can be more than two, three, four, five, or six sites.
  • FVIII is cleaved right after Arginine at amino acid 1648 (in full-length Factor VIII or SEQ ID NO: 16), amino acid 754 (in the S743/Q1638 B- domain deleted Factor VIII or SEQ ID NO: 16), or the corresponding Arginine residue (in other variants), thereby resulting in a heavy chain and a light chain.
  • FVIII comprises a heavy chain and a light chain, which are linked or associated by a metal ion-mediated non-covalent bond.
  • FVIII is a single chain FVIII that has not been cleaved right after Arginine at amino acid 1648 (in full-length FVIII or SEQ ID NO: 16), amino acid 754 (in the S743/Q1638 B-domain-deleted FVIII or SEQ ID NO: 18), or the corresponding Arginine residue (in other variants).
  • a single chain FVIII may comprise one or more amino acid substitutions.
  • the amino acid substitution is at a residue corresponding to residue 1648, residue 1645, or both of full-length mature Factor VIII polypeptide (SEQ ID NO: 16) or residue 754, residue 751, or both of SQ BDD Factor VIII (SEQ ID NO: 18).
  • the amino acid substitution can be any amino acids other than Arginine, e.g., isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, valine, alanine, asparagine, aspartic acid, cysteine, glutamic acid, glutamine, glycine, proline, selenocysteine, serine, tyrosine, histidine, ornithine, pyrrolysine, or taurine.
  • Arginine e.g., isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, valine, alanine, asparagine, aspartic acid, cysteine, glutamic acid, glutamine, glycine, proline, selenocysteine, serine, tyrosine, histidine, ornithine, pyrrol
  • FVIII can further be cleaved by thrombin and then activated as FVIIIa, serving as a cofactor for activated Factor IX (FIXa). And the activated FIX together with activated FVIII forms a Xase complex and converts Factor X to activated Factor X (FXa).
  • FVIII is cleaved by thrombin after three Arginine residues, at amino acids 372, 740, and 1689 (corresponding to amino acids 372, 740, and 795 in the B-domain deleted FVIII sequence), the cleavage generating FVIIIa having the 50kDa Al, 43kDa A2, and 73kDa A3-C1-C2 chains.
  • the FVIII protein useful for the present invention is non-active FVIII.
  • the FVIII protein is an activated FVIII.
  • the protein having FVIII polypeptide linked to or associated with the VWF fragment can comprise a sequence at least 50%, 60%, 70%, 80%, 90%, 95%, 96%, 97%, 98%, 99%, or 100% identical to SEQ ID NO: 16 or 18, wherein the sequence has the FVIII clotting activity, e.g., activating Factor IX as a cofactor to convert Factor X to activated Factor X (FXa).
  • FXa Factor IX as a cofactor to convert Factor X to activated Factor X
  • Hybrid polypeptides and proteins means a combination of a first polypeptide chain, e.g., the VWF fragment, optionally fused to a first heterologous moiety, with a second polypeptide chain, e.g., a FVIII protein, optionally fused to a second heterologous moiety, thereby forming a heterodimer.
  • first polypeptide and the second polypeptide in a hybrid are associated with each other via protein-protein interactions, such as charge-charge or hydrophobic interactions.
  • the first polypeptide and the second polypeptide in a hybrid are associated with each other via disulfide or other covalent bond(s).
  • the second polypeptide may be an identical copy of the first polypeptide or a non-identical polypeptide.
  • the first polypeptide is a VWF fragment-Fc fusion protein
  • the second polypeptide is a polypeptide comprising, consisting essentially of, or consisting of an FcRn binding domain, wherein the first polypeptide and the second polypeptide are associated with each other.
  • the first polypeptide comprises a VWF fragment-Fc fusion protein
  • the second polypeptide comprises FVIII-Fc fusion protein, making the hybrid a heterodimer.
  • the first polypeptide and the second polypeptide can be associated through a covalent bond, e.g., a disulfide bond, between the first Fc region and the second Fc region.
  • the first polypeptide and the second polypeptide can further be associated with each other by binding between the VWF fragment and the FVIII protein.
  • the chimeric protein of the present invention further comprises a linker.
  • One or linkers can be present between any two proteins, e.g., between the adjunct moiety and the FVIII protein (sometimes also referred to as "FVIII/AM linker”), between the VWF fragment and a first heterologous moiety (sometime also referred to as "VWF linker"), e.g., a first Fc region, between a FVIII protein and a second heterologous moiety (sometimes also referred to as "FVIII linker”), e.g., a second Fc region, between the VWF fragment and a FVIII protein (e.g., FVIII/AM linker), between the VWF fragment and a second heterologous moiety, and/or between a FVIII protein and a first heterologous moiety.
  • Each of the linkers can have the same or different sequence.
  • the linker is a polypeptide linker.
  • the linker is a non-polypeptid
  • the linker useful in the present invention can comprise any organic molecule.
  • the linker is a polymer, e.g., polyethylene glycol (PEG) or hydroxyethyl starch (HES).
  • the linker is an amino acid sequence (e.g., a polypeptide linker).
  • the polypeptide linker can comprise at least about 10, 20, 30, 40, 50, 60, 70, 80, 90, 100, 150, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1100, 1200, 1300, 1400, 1500, 1600, 1700, 1800, 1900, or 2000 amino acids.
  • the linker can comprise 1-5 amino acids, 1-10 amino acids, 1-20 amino acids, 10-50 amino acids, 50-100 amino acids, 100-200 amino acids, 200-300 amino acids, 300-400 amino acids, 400-500 amino acids, 500-600 amino acids, 600-700 amino acids, 700-800 amino acids, 800-900 amino acids, or 900-1000 amino acids.
  • the linker comprises the sequence G n .
  • the linker can comprise the sequence (GA) n .
  • the linker can comprise the sequence (GGS) n .
  • the linker comprises (GGGS) n (SEQ ID NO: 20).
  • the linker comprises the sequence (GGS) n (GGGGS) n (SEQ ID NO: 21).
  • n may be an integer from 1-100.
  • n may be an integer from 1-20, i.e., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, or 20.
  • linkers include, but are not limited to, GGG, SGGSGGS (SEQ ID NO: 22), GGSGGSGGSGGSGGG (SEQ ID NO: 23), GGSGGSGGGGSGGGGS (SEQ ID NO: 24), GGSGGSGGSGGSGGSGGS (SEQ ID NO: 25), GGGGSGGGGSGGGGS (SEQ ID NO: 26), the linkers in Table 13 (SEQ ID NOs: 92, 93, and 94), and the linkers in Table 14A (SEQ ID NOs: 95, 96 and 97).
  • the linker does not eliminate or diminish the VWF fragment activity or the clotting activity of Factor VIII.
  • the linker enhances the VWF fragment activity or the clotting activity of Factor VIII protein, e.g., by further diminishing the effects of steric hindrance and making the VWF fragment or Factor VIII portion more accessible to its target binding site.
  • the linker useful for the chimeric protein is 15-25 amino acids long. In another embodiment, the linker useful for the chimeric protein is 15-20 amino acids long. In some embodiments, the linker for the chimeric protein is 10-25 amino acids long. In other embodiments, the linker for the chimeric protein is 15 amino acids long. In still other embodiments, the linker for the chimeric protein is (GGGGS) n (SEQ ID NO: 27) where G represents glycine, S represents serine and n is an integer from 1-20.
  • the linker may also incorporate a moiety capable of being cleaved either chemically (e.g., hydrolysis of an ester bond), enzymatically (i.e., incorporation of a protease cleavage sequence), or photolytically (e.g., a chromophore such as 3-amino-3-(2- nitrophenyl) proprionic acid (ANP)) in order to release one molecule from another.
  • a moiety capable of being cleaved either chemically (e.g., hydrolysis of an ester bond), enzymatically (i.e., incorporation of a protease cleavage sequence), or photolytically (e.g., a chromophore such as 3-amino-3-(2- nitrophenyl) proprionic acid (ANP)
  • the linker is a cleavable linker.
  • the cleavable linkers can comprise one or more cleavage sites at the N-terminus or C-terminus or both.
  • the cleavable linker consists essentially of or consists of one or more cleavable sites.
  • the cleavable linker comprises heterologous amino acid linker sequences described herein or polymers and one or more cleavable sites.
  • a cleavable linker comprises one or more cleavage sites that can be cleaved in a host cell (i.e., intracellular processing sites).
  • cleavage site include RRRR (SEQ ID NO: 52), RKRRKR (SEQ ID NO: 53), and RRRRS (SEQ ID NO: 54).
  • a cleavable linker comprises one or more cleavage sites that are cleaved by a protease after a chimeric protein comprising the cleavable linker is administered to a subject.
  • the cleavage site is cleaved by a protease selected from the group consisting of factor XIa, factor Xlla, kallikrein, factor Vila, factor IXa, factor Xa, factor Ila (thrombin), Elastase-2, MMP-12, MMP-13, MMP-17, and MMP-20.
  • the cleavage site is selected from the group consisting of a FXIa cleavage site (e.g., KLTR j AET (SEQ ID NO: 29)), a FXIa cleavage site (e.g, DFTR j VVG (SEQ ID NO: 30)), a FXIIa cleavage site (e.g., TMTR j IVGG (SEQ ID NO: 31)), a Kallikrein cleavage site (e.g., SPFR j STGG (SEQ ID NO: 32)), a FVIIa cleavage site (e.g., LQVR I IVGG (SEQ ID NO: 33)), a FIXa cleavage site (e.g., PLGR I IVGG (SEQ ID NO: 34)), a FXa cleavage site (e.g., IEGR I TVGG (SEQ ID NO: 35)), a Flla (thrombin) cle
  • the FXIa cleavage sites include, but are not limited to, e.g., TQSFNDFTR (SEQ ID NO: 47) and SVSQTSKLTR (SEQ ID NO: 48).
  • Non-limiting exemplary thrombin cleavage sites include, e.g., DFLAEGGGVR (SEQ ID NO: 49), TTKIKPR (SEQ ID NO: 50), or LVPRG (SEQ ID NO: 55), and a sequence comprising, consisting essentially of, or consisting of ALRPR (e.g., ALRPRVVGGA (SEQ ID NO: 51)).
  • the cleavage site is N-(2-aminoethyl)-2-aminoethyl-N-(2-aminoethyl)-2-aminoethyl-N-(2-aminoethyl)-2-aminoethyl-N-(2-aminoethyl)-2-aminoethyl-N-(2-aminoethyl)-2-aminoethyl-N-(2-aminoethyl)-2-aminoethyl-N-(2-aminoethyl)-2-aminoethyl-N-(2-aminoethyl)-2-aminoethyl-N-(2-aminoethyl)-2-aminoethyl-N-(2-aminoethyl)-2-aminoethyl-N-(2-aminoethyl)-2-aminoethyl-N
  • Also provided in the invention is a polynucleotide encoding a VWF fragment described herein, a chimeric protein comprising the VWF fragment and a heterologous moiety, a chimeric protein comprising a FVIII protein and an adjunct moiety, or a chimeric protein comprising a VWF fragment and a FVIII protein.
  • a VWF fragment is linked to a heterologous moiety or a FVIII protein in a chimeric protein as a single polypeptide chain
  • the invention is drawn to a polynucleotide encoding the VWF fragment linked to the heterologous moiety or the FVIII protein.
  • a polynucleotide can comprise the first nucleotide sequence and the second nucleotide sequence.
  • the first nucleotide sequence and the second nucleotide sequence are on the same polynucleotide.
  • the first nucleotide sequence and the second nucleotide sequence are on two different polynucleotides (e.g., different vectors).
  • the present invention is directed to a set of polynucleotides comprising a first nucleotide chain and a second nucleotide chain, wherein the first nucleotide chain encodes the VWF fragment of the chimeric protein and the second nucleotide chain encodes the FVIII protein.
  • the set of the polynucleotides further comprises an additional nucleotide chain (e.g., a second nucleotide chain when the chimeric polypeptide is encoded by a single polynucleotide chain or a third nucleotide chain when the chimeric protein is encoded by two polynucleotide chains) which encodes a protein convertase.
  • an additional nucleotide chain e.g., a second nucleotide chain when the chimeric polypeptide is encoded by a single polynucleotide chain or a third nucleotide chain when the chimeric protein is encoded by two polynucleotide chains
  • the protein convertase can be selected from the group consisting of proprotein convertase subtilisin/kexin type 5 (PCSK5 or PC5), proprotein convertase subtilisin/kexin type 7 (PCSK7 or PC5), a yeast Kex 2, proprotein convertase subtilisin/kexin type 3 (PACE or PCSK3), and two or more combinations thereof.
  • the protein convertase is PACE, PC5, or PC7.
  • the protein convertase is PC5 or PC7. See International Application no. PCT/US2011/043568, which is incorporated herein by reference.
  • the protein convertase is PACE/Furin.
  • the invention includes a set of the polynucleotides comprising a first nucleotide sequence encoding a VWF fragment comprising a D' domain and a D3 domain of VWF, a second nucleotide sequence encoding a FVIII protein, and a third nucleotide sequence encoding a Dl domain and D2 domain of VWF.
  • the Dl domain and D2 domain are separately expressed (not linked to the D'D3 domain of the VWF fragment) in order for the proper disulfide bond formation and folding of the D'D3 domains.
  • the D1D2 domain expression can either be in cis or trans.
  • an expression vector refers to any nucleic acid construct which contains the necessary elements for the transcription and translation of an inserted coding sequence, or in the case of an RNA viral vector, the necessary elements for replication and translation, when introduced into an appropriate host cell.
  • Expression vectors can include plasmids, phagemids, viruses, and derivatives thereof.
  • Expression vectors of the invention will include polynucleotides encoding the

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LT13735649T LT2804623T (lt) 2012-01-12 2013-01-12 Chimeriniai viii faktoriaus polipeptidai ir jų panaudojimas
SI201331602T SI2804623T1 (sl) 2012-01-12 2013-01-12 Himerni polipeptidi faktorja VIII in njihove uporabe
KR1020147022369A KR102212098B1 (ko) 2012-01-12 2013-01-12 키메라 인자 viii 폴리펩티드들과 이의 용도
DK13735649T DK2804623T3 (da) 2012-01-12 2013-01-12 Kimære faktor viii-polypeptider og anvendelser deraf
NZ626945A NZ626945A (en) 2012-01-12 2013-01-12 Chimeric factor viii polypeptides and uses thereof
CA2863328A CA2863328A1 (en) 2012-01-12 2013-01-12 Chimeric factor viii polypeptides and uses thereof
MX2014008512A MX357403B (es) 2012-01-12 2013-01-12 Polipeptidos de factor viii quimericos y usos de los mismos.
CN201380013452.7A CN104271150A (zh) 2012-01-12 2013-01-12 嵌合因子viii多肽及其用途
EP13735649.9A EP2804623B1 (en) 2012-01-12 2013-01-12 Chimeric factor viii polypeptides and uses thereof
EP18211179.9A EP3505179A1 (en) 2012-01-12 2013-01-12 Chimeric factor viii polypeptides and uses thereof
US14/371,948 US11370827B2 (en) 2012-01-12 2013-01-12 Chimeric factor VIII polypeptides and uses thereof
SG11201403764XA SG11201403764XA (en) 2012-01-12 2013-01-12 Chimeric factor viii polypeptides and uses thereof
ES13735649T ES2753124T3 (es) 2012-01-12 2013-01-12 Polipéptidos quiméricos de factor VIII y usos de los mismos
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